肾部分切除术患者术后急性肾功能损伤出入量观测的最佳时间窗研究  

Study on the optimal time window for observing intake and output in patients with acute renal injury undergoing partial nephrectomy

作　　者：蔡海晶 张成伟 CAI Haijing;ZHANG Chengwei(Department of Urology,Drum Tower Hospital Affiliated to Nanjing University School of Medicine,Nanjing,Jiangsu 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院泌尿外科,南京210008

出　　处：《重庆医学》2023年第15期2277-2281,共5页Chongqing medicine

基　　金：国家自然科学基金项目(81902581)。

摘　　要：目的研究肾部分切除术患者术后急性肾功能损伤出入量观测的最佳时间窗。方法选取2019年10月至2021年10月该院行肾部分切除术的肾癌患者131例作为研究对象,将术后急性肾损伤患者21例纳入急性肾损伤组,将术后无急性肾损伤患者110例纳入无急性肾损伤组,对所有患者临床资料进行回顾性分析。对比两组一般情况、围手术期指标、术后各时间窗出入量分布情况,分析患者术后急性肾功能损伤出入量观测的最佳时间窗,以及患者术后急性肾损伤的独立危险因素。结果急性肾损伤组热缺血时间长于无急性肾损伤组,术后1年肾功能正常率低于无急性肾损伤组,差异均有统计学意义(P<0.05)。急性肾损伤组术后10、12、14、16、18 h出入量均高于无急性肾损伤组,差异有统计学意义(P<0.05)。经曲线下面积(AUC)-受试者工作特征(ROC)曲线分析,术后10 h是患者术后急性肾功能损伤出入量观测的最佳时间窗。经多元logistic回归分析,热缺血时间、术后10 h时间窗出入量是患者术后急性肾损伤的独立危险因素(P<0.05)。结论热缺血时间、术后10 h时间窗出入量是患者术后急性肾损伤的独立危险因素,术后10 h是患者术后急性肾功能损伤出入量观测的最佳时间窗。Objective To investigate the optimal time window for observing the intake and output of acute renal injury in patients undergoing partial nephrectomy.Methods From October 2019 to October 2021,we selected 131 patients with kidney cancer who underwent partial nephrectomy in our hospital as the subjects of our research.Among them,21 patients developed postoperative acute kidney injury and were included in the acute kidney injury group,while patients without postoperative acute kidney injury were also included.110 cases were included in the non-acute kidney injury group,and the clinical data of all patients were analyzed retrospectively.The study compared the general conditions,perioperative indicators,and the distribution of postoperative intake and output between the two groups.It also analyzed the optimal time window for observing postoperative acute renal injury intake and output,as well as the independent risk factors for postoperative acute kidney injury in patients.Results The warm ischemia time in the acute kidney injury group was longer than that in the non-acute kidney injury group,and the rate of normal renal function 1 year after the operation was lower in the acute kidney injury group compared to the non-acute kidney injury group.These differences were statistically significant(P<0.05).The intake and output of the acute kidney injury group at 10,12,14,16,and 18 hours after the operation were higher than those of the non-acute kidney injury group,and the difference was statistically significant(P<0.05).According to the analysis of the area under the curve(AUC)of the receiver operating characteristic(ROC)curve,the best time window for observing the intake and output of patients with postoperative acute renal injury was 10 hours after the operation.According to multiple logistic regression analysis,warm ischemia time and postoperative 10-hour time window intake and output were identified as independent risk factors for postoperative acute kidney injury(P<0.05).Conclusion The duration of warm ischemia and th

关 键 词：肾部分切除术 急性肾功能损伤 出入量 最佳时间窗 独立危险因素 

分 类 号：R587[医药卫生—内分泌]