关节置换术后发生急性肾损伤的危险因素分析

Risk factors of acute kidney injury following arthroplasty

目的探讨关节置换术后急性肾损伤(AKI)的发生率和危险因素,为临床防治关节置换术后发生AKI提供参考。方法回顾性选取2009年1月至2016年12月行关节置换术的患者3 238例,筛选出所有术后发生AKI的患者,以未发生AKI的患者为对照,按1:3配对。单因素分析两组患者的临床资料,并采用logistic回归分析关节置换术后发生AKI的危险因素。结果关节置换术后发生AKI的患者共71例,发生率为2.2%。高龄(OR=1.055,95%CI:1.014~1.098)、BMI高(OR=1.384,95%CI:1.147~1.670)、高血压(OR=6.646,95%CI:3.251~13.587)、术前肾功能异常(OR=8.594,95%CI:2.934~25.168)、围术期输血(OR=4.458,95%CI:1.578~12.597)是关节置换术后发生AKI的独立危险因素(均P<0.05)。结论高龄、高BMI、高血压、术前肾功能异常、围术期输血患者关节置换术后应警惕发生AKI,做好预防措施。

Objective To analyze the risk factors of acute kidney injury （AKI） in patients following arthroplasty. MethodsTotal3 238 patients underwent joint replacement operations from January 2009 to December 2016 patients, among whom AKIoccurred in 71 cases （2.2%）. The clinical data were collected and the risk factors of AKI were analyzed by Logistic regression.Results The factors associated with AKI included advanced age（OR=1.055, 95%CI1.014-1.098）, high body mass index（OR=1.384, 95%CI：1.147-1.670）, hypertension（OR=6.646, 95%CI：3.251-13.587）, preoperative renal dysfunction（OR=8.594, 95%CI：2.934-25.168）, peri-operative blood transfusion（OR=4.458, 95%CI： 1.578-12.597）. Conclusion For patients with advancedage, high BMI, hypertension and preoperative renal function abnormality, if they are scheduled to undergo arthroplasty,preventive measures should be taken to avoid acute kidney injury.