高龄食管癌患者术后并发急性肾损伤的治疗研究  

Treatment of postoperative acute renal injury in elderly patients with esophageal carcinoma

作　　者：董谦[1] 黄闰莹[2] 

机构地区：[1]浙江省肿瘤医院ICU,杭州310022 [2]浙江大学医学院附属邵逸夫医院,杭州310007

出　　处：《中国生化药物杂志》2016年第5期101-103,共3页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的探究高龄食管癌病患术后并发急性肾损伤（acute kidney injury,AKI）的危险因素,并分析临床治疗效果。方法选择2012年1月~2015年12月在浙江省肿瘤医院手术治疗术后并发AKI的28例高龄食管癌患者随机分为观察组和对照组各14例。观察组采用血液净化联合法舒地尔治疗,对照组仅行血液净化治疗。对比2组治疗前后血清肌酐（SCr）、尿素氮（BUN）、白细胞介素-7（IL-7）以及基质金属蛋白酶-8（MMP-8）指标。结果通过Logistic回归分析,得到4个影响高龄食管癌病患术后并发AKI的危险因素,即：高龄、高血压、糖尿病以及术后肺部感染。观察组和对照组2组治疗后SCr、BUN肾功能指标以及IL-7、MMP-8炎症因子水平较治疗前显著降低,且观察组SCr、BUN、IL-7、MMP-8水平均显著低于对照组,差异均有统计学意义（均P〈0.05）。结论年龄以及伴发高血压、糖尿病以及术后肺部感染是造成高龄食管癌病患术后并发AKI的危险因素,临床上应对相应食管癌人群进行严密监测以降低术后AKI发生率。其中采用血液净化联合法舒地尔治疗食管癌术后并发AKI病患效果显著。Objective To explore risk factors of elderly patients with esophageal cancer after operation with acute kidney injury （AKI） and analyse the clinical treatment effect. Methods From January 2012 to December 2015, 28 patients of elderly patients with esophageal cancer after operation with AKI were randomly divided into observation group and control group. The observation group were treated with blood purification combined with fasudil treatment, the control group only received blood purification treatment. Serum creatinine （SCr） urea nitrogen （BUN） and interleukin -7 （IL-7） and matrix metalloproteinase -8 （MMP-8） before and after treatment between the two groups were compared. Four risk factors were associated with elderly patients with esophageal cancer after operation with AKI, namely： advanced age, hypertension, diabetes and postoperative pulmonary infection by Logistic regression analysis. The renal function indicators of SCr, BUN and inflammatory factors of IL-7, MMP-8 post-treatment were lower than pre-treatment, and the above indicators in observation group were lower than control group, there were significant differences （ all P 〈 0. 05 ） . Conclusion Age, hypertension, diabetes and postoperative pulmonary infection are risk factors for elderly patients with esophageal cancer postoperative AKI, and the corresponding esophageal cancer patients with the above risk factors should be closely monitored in order to reduce the incidence of postoperative AKI. The hemopurification combined with fasudil has an obvious efficacy.

关 键 词：食管癌 术后并发症 急性肾损伤 危险因素 血液净化 法舒地尔 

分 类 号：R586.11[医药卫生—内分泌]