非体外循环下冠状动脉旁路移植术后急性肾损伤危险因素分析  

Analysis of the risk factors acute kidney injury after off-pump coro- nary artery bypass surgery

作　　者：郭建中[1] 李大连[1] 程智广[1] 崔永超[1] 李莹莹[1] 张永[1] 

机构地区：[1]首都医科大学附属北京友谊医院心脏中心心血管外科,北京100050

出　　处：《国际外科学杂志》2014年第11期747-750,共4页International Journal of Surgery

摘　　要：目的分析出非体外循环下行冠状动脉旁路移植术后早期发生急性肾损伤的单因素和多因素危险因子。方法分析2011年1月-2013年12月在非体外循环下行冠状动脉旁路移植术261例患者的临床资料，根据临床诊断AKI的标准，术后发生急性肾损伤的患者29例（AKI组），男22例，女7例，平均年龄（68．74±10．27）岁；未发生急性肾损伤的患者232例（非AKI组），男179例，女53例，平均年龄（66．26±9．82）岁。总结术前血压、左心室射血分数（LVEF）、左心室内径、血肌酐及术后并发症等，利用SPSS统计软件对急性肾损伤有关的因素进行Logistic回归分析。结果全组AKI发病率为11．11％（29／261），住院死亡1例。统计学分析结果显示，术前血肌酐含量、麻醉时间、围术期输血是导致冠状动脉旁路移植术后发生AKI的危险因素。结论AKI是冠状动脉旁路移植术后常见的并发症，术前应认真评估危险因素，加强肾功能保护才能降低AKI发生的风险。Objective Univariate analysis and multivariate risk factors of early acute kidney injury on off-pump coronary artery bypass grafting are performed. Methods Analyzed retrospectively the clinical date of 261 patients who underwent off-pump coronary artery bypass surgery between Jan 2011 to Dec 2013. According to the clinical diagnostic ctriteria, 261 patients were divided into AKI group （ n = 29 ） and NAKI group （ n = 232 ）. There were 22 males and 7 females With an age of （68.74 ±10.27） years in the AKI group, there were t79 males and 53 fe- males with an age of （66.26 ±9.82 ） years in the NAKI group, we summarize the clinical date, including blood pressure, left ventricular ejecting fraction, diameter of the left ventricle and serum creatinine before operation, and observed postoperative complications etc. Evaluated the factors for AKI Using Logistics regression analysis statistical methods. Results Among all the patients, the incidence of AKI was 11.11% （29/261）, 1 patients died in all the patients for AKI. The statistical analysis revealed that the serum creatinine after operation, anesthesia time, and perioperative blood transfusion were the risk factors for acute injury after off-pump coronary artery bypass surgery.

关 键 词：冠状动脉旁路移植术 非体外循环 急性肾损伤 危险因素 发病率 

分 类 号：R654.2[医药卫生—外科学]