A型主动脉夹层患者术后行连续性肾脏替代治疗的危险因素分析  

Risk Factors for Continuous Renal Replacement Therapy in Patients with Type A Aortic Dissection

作　　者：史晨[1] 张岩[1] 陈祖君[1] 裴锋博[1] 杨秋兰[1] SHI Chen;ZHANG Yan;CHEN Zujun;PEI Fengbo;YANG Qiulan(Department of Adult Cardiovascular Surgery,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100037,China)

机构地区：[1]中国医学科学院,北京协和医学院,国家心血管病中心,阜外医院成人外科中心,北京市100037

出　　处：《中国分子心脏病学杂志》2022年第4期4764-4768,共5页Molecular Cardiology of China

基　　金：北京协和医学院教育教学改革项目(10023201900202)。

摘　　要：目的分析影响A型主动脉夹层患者术后行连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)的风险因素。方法回顾性选取2015—2017年收治的A型主动脉夹层患者449例作为研究对象,根据术后患者是否行CRRT,将患者分为非CRRT组(n=352)和CRRT组(n=97),并纳入两组患者术前、术中及术后的相关指标,分析A型主动脉夹层术后患者行CRRT的危险因素。结果采用logistic分析发现,影响A型主动脉夹层术后患者行CRRT发生风险的关键因素为术前血肌酐值、术中停循环时间、出血量、术中输血量。相比于非CRRT组,CRRT组患者的术前血肌酐值较高,术中停循环时间、出血量及输血量也明显较高,差异具有统计学意义(P<0.05)。术后30天内,CRRT组的死亡率(18.56%)显著高于非CRRT组的死亡率(9.38%),差异具有统计学意义(P<0.05)。结论术前血肌酐值、术中停循环时间、出血量以及术中输血量会导致A型主动脉夹层患者术后行CRRT发生风险的可能性增大。Objective To analyze the risk factors in postoperative patients with type A aortic dissection undergoing continuous renal replacement therapy(CRRT).Methods A total of 449 patients with type A aortic dissection treated in our hospital from 2015 to 2017 were retrospectively selected as the research subjects.According to whether the patients received CRRT after surgery,the patients were divided into the non-CRRT group(n=352)and the CRRT group(n=97).Preoperative,intraoperative and postoperative indicators were collected to analyze the risk factors of CRRT in patients with type A aortic dissection after surgery.Results Logistic analysis showed that the key factors affecting CRRT in patients with type A aortic dissection after surgery were preoperative creatinine,intraoperative circulatory stop time,blood loss and intraoperative blood transfusion.Compared with the non-CRRT group,the level of preoperative creatinine was higher in the CRRT group,and the intraoperative circulation stop time,blood loss and blood transfusion volume were also significantly higher,with statistically significant differences(P<0.05).Within 30 days after surgery,the mortality of the CRRT group(18.56%)was significantly higher than that of the non-CRRT group(9.38%),the difference was statistically significant(P<0.05).Conclusions Preoperative creatinine,intraoperative circulatory stop time,blood loss and intraoperative blood transfusion may increase the risk of postoperative CRRT in patients with type A aortic dissection.

关 键 词：主动脉夹层 A型主动脉夹层 危险因素 连续性肾脏替代治疗 

分 类 号：R654.3[医药卫生—外科学]