非紫绀型先天性心脏病患儿术后急性肾损伤的影响因素研究

[目的]探讨非紫绀型先天性心脏病患儿体外循环(CPB)心脏手术后急性肾损伤(AKI)的发病情况及相关危险因素.[方法]选择2013年10月至2015年10月在本院心胸外科行CPB手术的患儿128例作为研究对象,根据治疗后是否伴随AKI分为AKI组和非AKI组,其中AKI组25例,非AKI组103例.比较两组患儿一般临床资料,通过单因素分析确定患儿发生AKI的相关因素,采用多因素Logistic回归分析确定独立影响因素.[结果]单因素分析表明:年龄、体质量、伴随肺炎、伴随心衰、血肌酐值、尿酸值、手术时间、主动脉阻断时间、术后输血量、机械通气时间、是否伴随术后低血压、全血活化凝血时间、住院时间均为外科手术的治疗非紫绀型先天性心脏病患儿后伴随AKI的相关影响因素;多因素Logistic回归分析表明:年龄、体质量、伴随肺炎、伴随心衰、手术时间、主动脉阻断时间为其独立影响因素.[结论]外科手术治疗非紫绀型先天性心脏病患儿发生AKI早期属于可逆的损伤,及时治疗对患儿的预后影响较小.

Study of Acute Kidney Injury and Related Risk Factors on Children with Acyanotic Congeni tal Heart Disease after CPB Cardiac Surgery

[Objective]To study the incidence of acute kidney injury ( AKI) and related risk factors on children with acyanotic congenital heart disease after cardiopulmonary bypass ( CPB) cardiac surgery.[Methods]One hundred and twenty-eight patients with CPB surgery in our hospital from October 2013 to October 2015 were selected as the subjects.They were divided into AKI group and non AKI group on the basis with AKI complicated or not after treat-ment, with 25 cases in AKI group and 103 in non AKI group . The clinical data of the two groups were compared, and the related factors of AKI were determined by single factor analysis. Multivariate Logistic regression analysis was used to determine the independent factors.[Results]Single factor analysis showed that age, body mass, accompanied with pneumonia, heart failure, serum creatinine, uric acid, operative time, aortic clamping time, postoperative blood transfusion volume, mechanical ventilation time, postoperative hypotension, whole blood activated clotting time and hospitalization time were all of the related factors on children with acyanotic congenital heart disease after cardiopul-monary bypass ( CPB) cardiac surgery complicated with AKI. Multivariate Logistic regression analysis showed that age, body mass, accompanying pneumonia, concomitant heart failure, operation time, aortic occlusion time were in-dependent factors.[Conclusion] The complicated AKI after cardiac surgery on children with acyanotic congenital heart disease is a reversible injury at early stage, Prompt treatment is effective on the prognosis of diseased children.