肝切除术后急性肾损伤围手术期危险因素分析

Milan Zoka, R. Amy
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引用次数: 2

摘要

目的:探讨肝切除术患者发生急性肾损伤(AKI)的围手术期潜在危险因素。方法:对110例肝切除术患者进行回顾性分析。肾脏疾病:改善总体预后(KDIGO)标准用于急性肾损伤(AKI)的诊断。记录术前、术中、术后各项指标。然后通过单变量和多变量回归分析进行统计分析。结果:急性肾损伤17例(15.45%)。12例为1期AKI(70.6%), 4例为2期(23.5%),1例为3期(5.9%)。单因素回归分析确定的危险因素有ASA状态(p=0.023)、体重(p=0.001)、性别(p=0.01)和基线血清肌酐(p=0.031)。在多变量回归分析中,体重和美国麻醉师协会(ASA)状态也被确定为AKI发展的独立预测因素(p=0.014, p=0.021)。结论:急性肾损伤1-3期是肝切除术后常见的并发症。包括肥胖和合并症在内的危险因素可促进AKI的发展,因此可能为围手术期治疗提供合适的靶点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Perioperative risk factors for acute kidney injury following liver resection surgery
Aim: To investigate and identify potential perioperative risk factors for developing acute kidney injury (AKI) in patients undergoing liver resection. Methods: This is a retrospective analysis of a single cohort centre of 110 patients undergoing liver resection. The Kidney Disease: Improving Global Outcomes (KDIGO) criteria was used for acute kidney injury (AKI) diagnosis. Preoperative, intraoperative and postoperative variables were recorded. These were then statistically analysed through univariate and multivariate regression analysis. Results: Acute kidney injury occurred in 17 patients (15.45%). Twelve patients were stage 1 AKI (70.6%), four were reportedly in stage 2 (23.5%) and one patient was in stage 3 (5.9%). Risk factors were identified through univariate regression analysis were ASA status (p=0.023), weight (p=0.001), gender (p=0.01) and baseline serum creatinine (p=0.031). Weight and Americal Society of Anaesthesiologists (ASA) status were also identified in the multivariate regression analysis as being independent predictors for the development of AKI (p=0.014, p=0.021 respectively). Conclusion: Acute kidney injury stage 1–3 is a common complication following hepatectomy. Risk factors including obesity and presence of comorbidities can contribute to the development of AKI and thus may provide appropriate targets for perioperative treatment.
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