心内直视术后早期并发急性肾功能衰竭的危险因素

目的：探讨心脏直视术后并发急性肾功能衰竭（ARF）的危险因素。方法：选择我院2005年10月～2010年1月行心内直视手术患者1660例患者，ASAⅡ-Ⅳ级，根据术后24h内是否发生ARF，分为2组：ARF组与非ARF组(NARF组)，其中ARF组78例，NARF组1582例。可能的危险因素进行组间比较后，将差异有统计学意义的因素进行logistic回归分析，筛选发生ARF的危险因素。结果： logistic回归分析结果显示，术前血β2-微球蛋白高于正常值、术中体外循环时间长和术后长时间低心排出量综合征与术后早期并发ARF有关(p<0.05)。结论：心内直视手术患者术前血β2-微球蛋白高于正常值、术中体外循环时间长和术后长时间低心排出量综合征是术后早期并发ARF的危险因素。

Risk factor for development of early acute renal failure in patients with open-heart surgery

Objective：To determine the risk factor for development of early acute renal failure in patients with open-heart surgery.Methods：1660 ASAⅡ-Ⅳ patients in our hospital from October 2005 to January 2010 under open-heart surgery were divided into acute renal failure group (ARF group) and no acute renal failure group (NARF group).ARF group had 78 cases and NARF group had 1582 cases.We compared the possible risk factor between groups and then applied the logistic regression to identify the risk factor of ARF.Result：Logistic analysis indicated that serum β2-microglobin higher than normal value before operation, the cardiopulmanory bypass time and the low cardiac output syndrome after operation were closely correlated with development of early ARF after open-heart surgy.Conclusion： Serum β2-microglobin higher than normal value before operation, the cardiopulmanory bypass time and the low cardiac output syndrome after operation are the risk factors for early ARF after open-heart surgy.