肾部分切除术后急性肾损伤的早期监测指标

Early Monitoring Index of Acute Kidney Injury after Partial Nephrectomy

目的:总结探讨肾部分切除术后急性肾损伤的早期监测指标。方法:选择2015年1月~2016年8月期间某院收治的并施行肾部分切除手术的68例患者为研究对象,将术后48h发生肾损伤的患者划为肾损伤组,将术后48h未发生肾损伤的患者划为非肾损伤组,比较两组术中液体负平衡、手术时间、术后尿量、Cys-C(胱抑素C)、BUN(血清尿素氮)、尿β_2MG(β_2微球蛋白)、尿MALB(微量白蛋白)的差异。结果:肾损伤组液体负平衡量(512.5±6.8)ml、术后6h尿量(56.2±0.6)ml/h、MALB(152.2±2.6)mg/L明显低于非肾损伤组,而Cys-C(1.4±0.2)mg/L明显高于非肾损伤组,组间差异具体以统计学意义(P<0.05);术后6hCys-C水平对早期肾损伤的预测价值高于液体负平衡量预测价值及术后6h平均尿量的预测价值。结论:术后Cys-C水平急剧升高是灵敏的肾损伤早期监测指标,可推广使用。

Objective：To investigate monitoring index of acute kidney injury after partial nephrectomy.Methods：68 patients who were treated and received partial nephrectomy in a hospital from January 2015 to August 2016 were selected as the study subjects.After 48 hof surgery,the patients suffering from renal injury were classified as renal injury group,and the patients who did not have renal injury were classified as non renal injury group.The negative fluid balance,operative time,postoperative urine volume,Cys-C（cystatin C）and BUN（serum urea nitrogen（2MG）and urine beta 2 microglobulin（MALB）,urinary albumin）of the two groups were analyzed.Results：The liquid negative balance（512.5±6.8）ml,6h urine volume（56.2±0.6）ml/h,MALB（152.2±2.6）mg/L were significantly lower than those of non renal injury group,while Cys-C（1.4±0.2）mg/L was significantly higher than that of non renal injury group（P〈0.05）.The predictive value of Cys-C level 6h after surgery in the early stage of renal injury was higher than that of the liquid negative balance value and the predictive value of average urine volume after 6h of surgery.Conclusion：The rapid elevation of Cys-C level is a sensitive indicator for early monitoring of renal injury.