期刊文献+

成人肝移植术后早期急性肾损伤的发生和危险因素分析 被引量:4

Investigation of incidence and risk factors of early acute kidney injury in adults after orthotopic liver transplantation
原文传递
导出
摘要 目的:了解成人原位肝移植术后早期急性肾损伤(AKI)的发生情况,探讨术后早期发生AKI的危险因素。方法:回顾性分析2017年1-12月在上海交通大学医学院附属仁济医院接受原位肝移植患者的临床资料,观察患者术后48 h内AKI的发生率,分析术前、术中及术后临床情况与其相关性,用Logistic回归分析患者术后早期AKI发生的危险因素。结果:共301例患者符合入选标准,年龄(50. 35±0. 29)岁,男女比例3. 8∶1。其中94例(31. 2%)发生了术后早期AKI(AKI组),术后24,48和72 h血肌酐分别为(126. 41±51. 55),(126. 24±73. 41)和(116. 43±90. 00)μmol/L,明显高于未发生AKI患者(非AKI组)。两组患者术前Bun和Scr虽处于正常范围,但AKI组高于非AKI组:Bun[(5. 91±2. 87)vs (4. 92±2. 07) mmol/L, P=0. 003],Scr[(71. 13±21. 41) vs (63. 72±16. 43)μmol/L, P=0. 003]。多因素回归提示术中无肝期时间超过46 min(HR=1. 810,P=0. 038)和应用2种及以上的血管活性药物(HR=1. 859,P=0. 046)是术后早期AKI发生的独立危险因素。结论:肝移植术后早期AKI发生率高,与术前肾功能相关,术中无肝期时间较长及术中应用2种及以上的血管活性药物是术后48 h内AKI发生的独立危险因素。 Objective: To investigate the incidence of early acute kidney injury(AKI) after orthotopic liver transplantation(OLT) in adult patients, and to explore the risk factors for early AKI after OLT.Methods: The clinical data of patients in Shanghai Renji Hospital from January 2017 to December 2017 were retrospectively analyzed, and the occurrence of AKI within 48 hours after surgery was observed using KDIGO’s diagnosis of AKI. The correlation between preoperative, intraoperative and postoperative clinical conditions and the occurrence of early postoperative AKI in liver transplantation patients was analyzed, and logistic regression was applied to analyze the risk factors of early postoperative AKI.Results:(1) The average age of the 301 patients was(50. 35±0. 29) years old, male cases were 3. 8-fold more than female cases.(2) 94 patients(31. 2%) developed early postoperative AKI(AKI group), and the serum creatinine levels were(126. 41±51. 55),(126. 24±73. 41), and(116. 43±90. 00) μmol/L, respectively, at the end of 24, 48, and 72 h after the operation, which were significantly higher than those of non-AKI group.(3) Although within the normal range, serum Bun and Scr levels in AKI group were higher than in non-AKI group;the Bun levels were(5. 91±2. 87) mmol/L vs(4. 92±2. 07) mmol/L(P=0. 003), whereas Scr levels were(71. 13±21. 41) vs(63. 72±16. 43)μmol/L(P=0. 003),respectively. Multivariate logistic regression analysis suggested that the duration of intraoperative anhepatic stage exceeding 46 minutes(HR=1. 810, P=0. 038)and the intraoperative application of ≥2 kinds of vasoactive drugs(HR=1. 859, P=0. 046) were independent risk factors for early postoperative AKI.Conclusion: The incidence of early AKI after liver transplantation is still high, and is related to the level of preoperative renal function. The long intraoperative period without liver and the intraoperative application of ≥2 kinds of vasoactive drugs are independent risk factors for the occurrence of AKI 48 hours after surgery.
作者 李喆 尚晨 张志贇 朱铭力 邓羽霄 皋源 陈尉华 LI Zhe;SHANG Chen;ZHANG Zhiyun;ZHU Mingli;DENG Yuxiao;GAO Yuan;CHEN Weihua(Dept.of Critical Care Medicine,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127,China)
出处 《武汉大学学报(医学版)》 CAS 2020年第3期485-489,共5页 Medical Journal of Wuhan University
关键词 肾损伤 急性 肝移植 发生率 危险因素 Kidney Injury,Acute Liver Transplantation Incidence Risk Factor
  • 相关文献

同被引文献21

引证文献4

二级引证文献11

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部