主动脉夹层术后早期急性肾损伤的危险因素分析

目的探讨主动脉夹层手术后早期发生急性肾损伤的围术期危险因素。方法回顾性收集2006年1月-2013年6月在本院心血管外科接受主动脉夹层手术的104例患者的临床资料，根据KDIGO分级诊断标准将患者分为急性。肾损伤组和非急性肾损伤组，采用Logistic多因素回归分析术后发生急性。肾损伤的危险因素。结果术后48h内发生急性肾损伤78例（75．0％），12例（11．5％）术后需肾替代治疗，住院死亡5例（4．8％）。Logistic回归分析提示：体外循环时间、高血压和深低温停循环时间〉40min是主动脉夹层术后发生急性肾损伤的独立危险因素。结论主动脉夹层术后急性肾损伤的发生概率高。体外循环时间、高血压和深低温停循环时间〉40min是主动脉夹层术后发生急性。肾损伤的独立危险因素。

Analysis of risk factor of acute kidney injury in early stage after aortic dissection surgery

Objective To explore the risk factors of acute kidney injury in early stage after aortic dissection surgery. Methods Clinical data of 104 patients who underwent aortic dissection surgery admitted to our hospital from January 2006 to June 2013 were retrospectively analyzed. The patients were divided into two groups （AKI group and Non-AKI group） according to the KDIGO definition criteria and perioperative variables were analyzed in both groups. The risk factors of acute kidney injury were evaluated by multivariate logistic regression analysis. Results AKI occurred in 78 patients （75.0%） within early 48 hours postoperatively, 12 patients （11.5%） received renal replacement therapy and 5 patients （4.8%） died in hospital. The logistic regression analysis revealed that hypertension, cardiopulmonary bypass time and deep hypothermic circulatory arrest time over 40 minutes were the independent risk factors of acute kidney injury in early stage after aortic dissection surgery. Conclusion AKI is a very common complication after aortic dissection surgery. Hypertension, cardiopulmonary bypass time and deep hypothermic circulatory arrest time over 40 minutes are the independent risk factor of acute kidney injury in early stage after aortic dissection surgery.