重型颅脑损伤患者肾血管阻力指数变化与预后的关系  

Relationship between renal resistive index and prognosis of critically ill patients with severe craniocerebral injury

作　　者：王婳[1] 许兆军[1] 蔡挺[1] 刘鹏[1] 陈培服[1] 潘建能 WANG Hua;XU Zhaojun;CAI Ting(Department of Intensive Care Unit, Ningbo Secondary Hospital, Ningbo 315010, China)

机构地区：[1]宁波市第二医院重症医学科,315010

出　　处：《浙江医学》2018年第10期1066-1069,共4页Zhejiang Medical Journal

基　　金：宁波市重点学科-急诊医学科研项目(2016-B04)

摘　　要：目的探讨重型颅脑损伤患者肾血管阻力指数(RRI)变化及其与预后的关系。方法选取55例重型颅脑损伤患者,使用彩色多普勒床旁超声诊断仪的腹部探头获得双侧RRI,同时观察患者的生命体征及肾功能等指标,比较手术组(28例)和非手术组(27例)RRI的变化、生存率的差异及其与预后的关系。结果两组患者的RRI与年龄、肌酐、尿素氮、APACHEⅡ评分呈正相关,与舒张压、尿量呈负相关(均P<0.05);手术组患者双侧、左侧、右侧RRI平均值分别为0.606±0.038、0.607±0.043、0.606±0.044,非手术组患者分别为0.664±0.049、0.666±0.057、0.657±0.054。两组患者RRI在双侧和左、右侧比较差异均有统计学意义(均P<0.01)。入科第1天非手术组患者的RRI即明显升高,手术组患者的平均生存时间(27.89±17.42)d,非手术组为(19.48±10.20)d。两组患者7、14d生存率差异无统计学意义(P>0.05),30、60d比较差异有统计学意义(P<0.05)。结论 RRI可以早期发现急性肾损伤的存在,非手术组患者RRI升高,生存时间短于手术组患者,提示预后不良,死亡风险增高。Objective To investigate the relationship between renal resistive index（RRI）and the prognosis of patients with severe craniocerebral injury.Methods Fifty-five severe brain injury patients admitted in our hospital were enrolled,including 28 cases undergoing surgery and 27 cases without surgery.The bilateral RRI was obtained with a color Doppler bedside ultrasound probe.The vital signs and renal function were also observed.The relationship between RRI and survival rate was analyzed.ResultsThe RRI was positively correlated with age,creatinine,urea nitrogen,and APACHEⅡscores,and negatively correlated with diastolic blood pressure and urine volume（P〈0.05）.The mean values of RRI on the lateral,left,and right sides in surgical group were 0.606±0.038,0.607±0.043 and 0.606±0.044,respectively,and those in the non-surgical group were 0.664±0.049,0.666±0.057,and 0.657±0.054（all P〈0.01）.The RRI value of patients in the non-surgical group on the first day of admission was significantly higher.The average survival time of patients in the surgical group was（27.89±17.42）days,and（19.48±10.20）days in the non-surgical group（P〈0.05）.There was no significant difference in 7-and14-day survival rates between two groups（P〉0.05）,while there was significant difference in 30-and 60-day survival rate between two groups（P〈0.05）.Conclusion The renal resistive index（RRI）can be used as an indicator for acute renal injury and predictor of survival of patients with severe craniocerebral injury.

关 键 词：肾血管阻力指数 重型颅脑损伤 多普勒超声 预后 

分 类 号：R651.15[医药卫生—外科学]