儿童非紫绀型先天性心脏病体外循环术后急性肾损伤相关危险因素分析

目的探究儿童非紫绀型先天性心脏病体外循环术后急性肾损伤(AKI)相关危险因素。方法选取2013年8月至2016年8月在湖南省儿童医院心胸外科行体外循环手术治疗的非紫绀型先天性心脏病患儿450例作为研究对象,将患儿按术后是否出现AKI进行分组,AKI组80例,非AKI组370例。收集患儿的一般资料及临床资料,通过单因素分析以及Logistic回归分析探究其相关危险因素。结果两组患儿在性别、体质量、尿素氮、左室射血分数、血红蛋白方面比较差异无统计学意义(P0.05)。两组在年龄、血肌酐、肺炎或心力衰竭史、体外循环时间及主动脉阻断时间、术后低血压方面比较差异有统计学意义(P0.05)。通过Logistic对因素回归分析发现,年龄≤1岁、肺炎或心力衰竭史、体外循环时间以及主动脉阻断时间是危险因素。结论在非紫绀型先天性心脏病患儿行体外循环手术治疗中,选择手术年龄、缩短体外循环时间、缩短主动脉阻断时间以及预防并发症是有效的控制手段,可以降低患儿AKI的发病率。

Analysis of the risk factors related to acute kidney injury after cadiopulmonary bypass for cyanotic congenital heart disease in children

Objective To investigate the risk factors related to acute kidney injury after cardiopulmonary bypass for non-cyanotic congenital heart disease in children.Methods A total of 450 children with non-cyanotic congenital heart disease were included as the research subjects, who received cardiopulmonary bypass in the Hunan Children's Hospital from Aug.2013 to Aug.2016.These children were divided into two groups based on whether AKI occurred after operation: AKI groups(80 children) and non-AKI group(370 children).The general and clinical data of the children were collected, and single factor analysis and logistic regression analysis were performed to investigate the related risk factors.Results there was no statistical difference in gender, body weight, urea nitrogen, left ventricular ejection fraction or hemoglobin between the two groups(P>0.05).There was statistical difference in age, serum creatinine, history of pneumonia or heart failure, cardiopulmonary bypass time and aortic clamping time or postoperative hypotension between the two groups(P<0.05).The Logistic regression analysis showed that the risk factors were as follows: age≤1 year old, history of pneumonia or heart failure, cardiopulmonary bypass time and aortic clamping time.Conclusion During the cardiopulmonary bypass surgery for children with non-cyanotic congenital heart disease, it is effective in controlling the disease to choose the proper age for operation, shorten the cardiopulmonary bypass time as well as the aortic clamping time, and to prevent complications, which can reduce the morbidity of AKI in children.