红细胞储存时间与体外循环心脏手术患儿术后急性肾损伤的关系  

Relationship between Erythrocyte Storage Duration and Acute Kidney Injury after Pediatric Cardiac Surgery with Cardiopulmonary Bypass

作　　者：付晓艳 甄自达 邱立娟[1] 张慧敏[1] 王孟键 马曙轩[1] FU Xiaoyan;ZHEN Zida;QIU Lijuan(Department of Blood Transfusion,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045)

机构地区：[1]北京国家儿童医学中心/首都医科大学附属北京儿童医院,北京100045

出　　处：《临床输血与检验》2023年第4期489-493,共5页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的探讨红细胞储存时间与体外循环(CPB)心脏外科手术患儿术后急性肾损伤(AKI)的关系。方法回顾性分析2019年1月—2022年12月在北京儿童医院心外科住院期间行手术治疗的患儿346例,收集患儿临床资料。根据CPB预充用红细胞储存时间分为新鲜红细胞组(≤14 d,n=163)和陈旧红细胞组(15~35 d,n=183),比较两组患儿术后AKI发生率及严重程度。结果346例患儿中有93例术后发生AKI,总发生率为26.88%。新鲜红细胞组患儿163例,术后47例(28.83%)发生AKI,其中AKI 1期28例(59.57%),AKI 2期15例(31.92%),AKI 3期4例(8.51%)。陈旧红细胞组患儿183例,术后46例(25.14%)发生AKI,其中AKI 1期28例(60.87%),AKI 2期16例(34.78%),AKI 3期2例(4.35%)。统计分析显示,两组患儿AKI发生率和严重程度差异均无统计学意义(发生率χ^(2)=0.600,P=0.439;严重程度χ^(2)=0.699,P=0.797)。结论术后AKI是心脏外科手术患儿常见的并发症,发生率为26.88%,但CPB预充用红细胞储存时间对术后AKI的发生率和严重程度没有影响。Objective This study is to investigatethe relationship between erythrocyte storage duration and acute kidney injury(AKI)after pediatric cardiac surgery with cardiopulmonary bypass(CPB).Methods A total of 346 consecutive pediatric patients from January 2019 to December 2022 who received cardiac surgery by CPB in Beijing Children's Hospital were retrospectively analysed.They were divided into fresher blood group(≤14 d,n=163)and older blood group(15~35 d,n=183)according to the erythrocyte storage duration.The incidence and severity of postoperative AKI were compared between two groups.Results A total of 346 subjects were included in the study.Among them,93 cases developed AKI after surgery,and the incidence rate was 26.88%.There were 163 children in the newer blood group,and 47(28.83%)had AKI after surgery,including 28 cases(59.57%)in AKI stage 1,15 cases(31.92%)in AKI stage 2,and 4 cases(8.51%)in AKI stage 3.There were 183 childrenin the older blood group,and 46 cases(25.14%)developed AKI after surgery,including 28 cases(60.87%)in AKI stage 1,16 cases(34.78%)in AKI stage 2,and 2 cases(4.35%)in AKI stage 3.The results showed that there was no significant difference in the incidence and severity of AKI between the two groups(incidence rateχ^(2)=0.600,P=0.439;severityχ^(2)=0.699,P=0.797).Conclusion AKI is a common complication following cardiac surgery with CPB in children,the incidence rate was 26.88%.But the duration of blood storage had no effect on the incidence of acute kidney injury after pediatric cardiac surgery with CPB.

关 键 词：红细胞储存时间 急性肾损伤 儿童体外循环 心脏外科手术 

分 类 号：R457[医药卫生—治疗学]