心脏瓣膜病换瓣术后肾功能损害的独立危险因素分析

Independent Risk Factors Analysis of Postoperative Renal Injury Undergoing Cardiac Valvular Surgery

目的探讨心脏瓣膜病换瓣术后肾功能损害的危险因素,为制订心脏瓣膜病换瓣术后肾功能损害的防治措施提供依据。方法选择宜昌市第一人民医院重症医学科心脏瓣膜病换瓣术后的患者71例,其中发生术后肾功能损害的27例患者作为病例组,术后肾功能无损害的44例患者为对照组。采用非条件Logistic回归分析法分析影响心脏瓣膜病换瓣术后肾功能损害的危险因素。结果单因素分析结果显示,升主动脉阻断时间≥70 min、体外循环时间≥120 min、年龄≥50岁、术前肾功损害是术后肾功能损害的高危因素;多因素结果分析显示,体外循环时间≥120 min(OR=4.937,95%CI 1.481～16.46)、术前肾功损害(OR=9.847,95%CI 1.016～95.42)是术后肾功能损害的独立危险因素。结论了解和掌握引起心脏瓣膜病换瓣术后肾功能损害的危险因素,可避免心脏瓣膜病换瓣术后的肾功能损害。

Objective To find out the risk factors of postoperative renal injury undergoing cardiac valvular surgery in ICU to provide reference for effective control measures.Methods The method of retrospective case-control study and multivariable logistic regression analysis were adopted to identify the risk factors of postoperative renal injury;71 patients undergoing cadiac vavular surgery in ICU of the First People＇s Hospital of Yichang,27 cases who had postoperative renal injury were chosen as the case group,44 without postoperative renal injury were chosen as the control group.Results Univariate analysis of risk factors for postoperative renal injury undergoing cardiac valvular surgery indicated that cross clamp time≥70 min,the CPB time ≥120 min,age≥50 y,preoperative renal damage were high risk factors for postoperative renal injury.The independent risk factors of postoperative renal injury undergoing cardiac valvular surgery were the CPB time ≥120 min（OR =4.937,95.0% CI 1.481-16.46）,preoperative renal damage（OR = 9.847,95.0% CI 1.016-95.42）.Conclusion Understanding and mastering the risk factors causing renal damage after heart valve disease surgery,may avoid renal dysfunction after the operation.