非小细胞肺癌术后并发急性肾功能不全的危险因素及护理对策分析

Risk factors and nursing countermeasures for postoperative acute renal dysfunction in patients with non-small cell lung cancer

目的探讨非小细胞肺癌术后并发急性肾功能不全的危险因素及护理对策。方法选取2016年1月至2020年1月间空军军医大学第二附属医院收治的经病理组织学确诊为非小细胞肺癌的90例患者的临床资料进行回顾性分析。将符合急性肾功能不全诊断标准的35例患者纳入研究组,不符合急性肾功能不全诊断标准的55例患者纳入对照组。对患者的危险因素进行单因素及多因素分析,并提出有效的护理措施。结果手术年龄60岁以上的患者术后发生急性肾功能不全的比例,高于60岁以内的患者,术前补液的患者术后发生急性肾功能不全的比例低于未补液的患者,差异均有统计学意义(均P<0.05)。术前使用血浆代用品的患者术后发生急性肾功能不全的比例,高于未使用血浆代用品的患者,差异均有统计学意义(均P<0.05)。结论手术年龄在60岁以上和术中使用血浆代用品是非小细胞肺癌患者术后并发急性肾功能不全的独立危险因素,术前适当补液可降低疾病发生概率。

Objective To analyze the risk factors and nursing strategies for postoperative acute re-nal dysfunction in patients with non-small cell lung cancer(NSCLC).Methods The clinical data of 90 patients with NSCLC diagnosed by histopathology were retrospectively analyzed at Tangdu Hospital,The Second Affiliated Hospital of Air Force Military Medical University from January 2016 to January 2020.Thirty-five patients meeting the diagnostic criteria of acute renal dysfunction were included in an experimen-tal group,and the remaining 55 patients were included in a control group.The risk factors for postoperative acute renal dysfunction were analyzed using univariate and multivariate analysis,and effective nursing strat-egies were put forward.Results The proportion of postoperative acute renal dysfunction was higher in pa-tients more than 60 years old than in patients less than 60 years old(P<0.05).The proportion of postop-erative acute renal dysfunction was lower in patients receiving preoperative fluid infusion than in patients without fluid infusion(P<0.05).However,the proportion postoperative acute renal dysfunction was higher in patients who used plasma substitutes before operation than in those who did not use plasma substitutes(P<0.05).OR value greater than 1 was a risk factor for postoperative acute renal dysfunction,and the higher OR value,the higher the risk of acute renal dysfunction,mainly including the use of plasma substi-tutes and over 60 years old.OR value less than 1 was a protective factor,and preoperative fluid infusion could reduce the incidence of postoperative acute renal dysfunction.Conclusion Patients more than 60 years old and the use of plasma substitutes during operation are independent risk factors for postoperative a-cute renal dysfunction in patients with non-small cell lung cancer.Preoperative fluid infusion is a protective factor.Appropriate preoperative fluid infusion can reduce the incidence of postoperative acute renal dysfunc-tion in non-small cell lung cancer.