机器人辅助下前列腺癌根治术术后发生急性肾损伤的危险因素  

Risk factors of acute kidney injury after robot-assisted radical prostatectomy:a single-centre retrospective study

作　　者：艾尼·买买提明 汪小海[1] 杨春[1] 陈洁[1] 徐鑫[1] 李勇[1] Aini Maimaitiming;Wang Xiaohai;Yang Chun;Chen Jie;Xu xin;Li Yong(Department of Anesthesiology,Nanjing Drum Tower Hospital,Medical College of Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,210008

出　　处：《中国医师进修杂志》2020年第12期1105-1108,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的:了解机器人辅助下前列腺癌根治术(RALP)术后发生肾损伤(AKI)的危险因素。方法:回顾性分析2017年6月至2019年6月南京大学附属鼓楼医院605例RALP患者临床资料,采用Logistic回归法分析影响术后AKI的影响因素。结果:单因素分析显示:年龄(P=0.001)、贫血(P=0.036)、低蛋白血症(P=0.001)、冠心病(P=0.040)、高血压(P=0.042)、服用血管紧张素转化酶抑制剂(ACEI)/血管紧张素Ⅱ受体拮抗剂(ARB)类降压药(P=0.025)、术中平均动脉压(MAP)<55 mmHg(1 mmHg=0.133 kPa)的时间(P=0.000)差异均有统计学意义(P<0.05);多因素Logistic回归分析示年龄(P=0.016)、低蛋白血症(P=0.009)、MAP<55 mmHg的时间(P=0.003)差异均有统计学意义(P<0.05)。结论:年龄、贫血、低蛋白血症、冠心病、高血压、服用ACEI/ARB类降压药、MAP<55 mmHg的时间均是术后患者发生AKI的危险因素;其中年龄、低蛋白血症、MAP<55 mmHg的时间是术后发生AKI的独立危险因素。临床上可以根据上述危险因素采取相应的预防措施,保护肾脏功能,降低围手术期病死率。Objective To explore the risk factors of acute kidney injury(AKI)after robot-assisted radical prostatectomy.Methods The clinical data of 605 patients who underwent robot-assisted radical prostatectomy in Nanjing Drum Tower Hospital from June 2017 to June 2019 were retrospectively analyzed.The independent risk factors of AKI were analyzed by Logistic regression.Results Univariate analysis showed that age(P=0.001),anemia(P=0.036),hypoalbuminemia(P=0.001),coronary heart disease(P=0.040),hypertension(P=0.042),use of ACEI/ARB drugs(P=0.025),duration of MAP<55 mmHg(1 mmHg=0.133 kPa)(P=0.000)presented statistical significance(P<0.05).Multivariate Logistic regression analysis showed that there were significant difference in age(P=0.016),hypoalbuminemia(P=0.009),duration of MAP<55 mmHg(P=0.003).Conclusions Age,anemia,hypoalbuminemia,coronary artery disease,hypertension,use of ACEI/ARB drugs,duration of MAP<55 mmHg are risk factors of postoperative AKI,among which age,hypoalbuminemia,duration of MAP<55 mmHg are independent risk factors.

关 键 词：前列腺肿瘤 机器人 急性肾损伤 危险因素 

分 类 号：R737.25[医药卫生—肿瘤]