嗜铬细胞瘤患者术后急性肾功能损伤的危险因素分析

目的探究嗜铬细胞瘤患者术后急性肾功能损伤(AKI)的独立危险因素。方法收集2005年1月至2017年10月行嗜铬细胞瘤手术患者的人口学信息、术前症状、合并症、实验室检查、肿瘤的位置和直径、手术时间、血管活性药物的使用情况、出入量、血流动力学指标等。采用Logistic回归模型分析嗜铬细胞瘤患者术后AKI的独立危险因素。结果共纳入308例患者,其中42例(13.6%)患者术后出现AKI。在单因素Logistic回归分析中,男性、糖尿病史、术前白蛋白<40 g/L、术前肌酐>95μmol/L、肿瘤直径>10 cm、手术时间>120 min、术中使用血管收缩药、术中人工胶体液输注≥2 000 ml、输注异体血、出血量≥1 000 ml和SBP<70%基础值累计时间>10 min与嗜铬细胞瘤患者术后AKI相关;多因素Logistic回归分析显示,男性、白蛋白<40 g/L、术中出血量≥1 000 ml和SBP<70%基础值累计时间>10 min是嗜铬细胞瘤术后AKI的独立危险因素。结论男性、白蛋白<40 g/L、术中出血量≥1 000 ml和SBP<70%基础值累计时间>10 min是嗜铬细胞瘤患者术后AKI的独立危险因素。

Analysis of risk factors for postoperative acute kidney injury in patients with pheochromocytoma

Objective To investigate the independent risk factors of postoperative acute kidney injury(AKI)in patients with pheochromocytoma.Methods A retrospective analysis of patients who underwent surgery for pheochromocytoma from January 2005 to October 2017.Data were collected retrospectively comprised of demographic characteristics,symptoms,comorbidities,laboratory test results,location and diameter of the tumor,duration of surgery,use of vasoactive drugs,fluid infusion,hemodynamic parameters,etc.The logistic regression model was adopted to analyze the independent risk factors of postoperative AKI in patients with pheochromocytoma.Results A total of 308 patients were enrolled,of whom 42(13.6%)had AKI after surgery.Univariate logistic regression analysis showed male,diabetes milletus,preoperative albumin<40 g/L,preoperative creatinine>95μmol/L,tumor diameter>10 cm,duration of surgery>120 min,intraoperative use of vasoconstrictors,intraoperative artificial colloidal solution infusion≥2000 ml,infusion of allogeneic blood,bleeding volume≥1000 ml and cumulative time of SBP<70%baseline>10 min were associated with postoperative AKI.Multivariate logistic regression analysis showed that male,preoperative albumin<40 g/L,bleeding volume≥1000 ml and cumulative time of SBP<70%baseline>10 min were independent risk factors for postoperative AKI.Conclusion Male,preoperative albumin<40 g/L,bleeding volume≥1000 ml and cumulative time of SBP<70%baseline>10 min are independent risk factors for postoperative AKI in patients with pheochromocytoma.