深低温停循环手术后急性肾损伤的影响因素分析

目的探讨深低温停循环手术后急性肾损伤发生的独立危险因素。方法收集2011年4月至2013年6月在深低温停循环下手术的91例患者的术后肌酐值。单因素分析引起术后肾损伤的各个因素,将有统计学差异的变量进行Logistic回归分析。结果多因素分析显示停循环时间(OR=1.038,CI:1.002~1.076,P=0.039)、既往高血压病史(OR=3.397,CI:1.007~11.457,P=0.049)、输血量(OR=1.001,CI:1.000~1.001,P=0.016)与术后急性肾损伤相关。急性肾损伤发生后呼吸机辅助时间、ICU停留时间延长。结论停循环时间、输血量、高血压病史是深低温停循环手术后急性肾损伤的独立危险因素,急性肾损伤发生后患者康复时间延长。

Risk factors for postoperative acute kidney injury of deep hypothemic circulatory arrest operation

Objective To investigate the independent risk factors of postoperative acute kidney injury（AKI） in deep hypothemic circulatory arrest（DHCA） operation. Methods Between April 2011 and June 2013,91 cases underwent DHCA operation were retrospectively analyzed. Univariate and Logistic regression analysis were used to identify the independent risk factors of postoperative AKI. Results Time of circulatory arrest（OR = 1. 038,CI： 1. 002 ~ 1. 076,P = 0. 039）,history of hypertension（OR = 3. 397, CI： 1. 007 ~ 11. 457,P = 0. 049） and transfusion volume（OR = 1. 001,CI： 1. 000 ~ 1. 001,P = 0. 016） were related to AKI. Time of ventilator and ICU admission increased after acute kidney injury. Conclusion Time of circulatory arrest,volume of transfusion and history of hypertension were independent risk factors of postoperative AKI of DHCA operation. Rehabilitation might prolong after AKI.