生物节律因素对体外循环心脏手术后AKI发生的影响:回顾性队列研究  

Effects of biorhythm factors on development of acute kidney injury after cardiac surgery using cardiopulmonary bypass:a retrospective cohort study

作　　者：李小东 文静 徐小 廖先建 宋雨汐 段家翔 鲁开智 易斌 甯交琳 Li Xiaodong;Wen Jing;Xu Xiao;Liao Xianjian;Song Yuxi;Duan Jiaxiang;Lu Kaizhi;Yi Bin;Ning Jiaolin(Department of Anaesthesiology,the First Affiliated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院麻醉科,重庆400038

出　　处：《中华麻醉学杂志》2024年第9期1093-1096,共4页Chinese Journal of Anesthesiology

基　　金：国家自然科学基金面上项目(82270095)。

摘　　要：目的:评价生物节律因素对体外循环心脏手术后急性肾损伤(AKI)发生的影响。方法:本研究为回顾性队列研究。收集2018年6月至2019年12月体外循环心脏手术患者的病例资料,按照实施麻醉手术的时间分为2组(n=125):上午节律组(Ⅰ组)8:00至12:00实施麻醉手术;下午节律组(Ⅱ组)14:00至18:00实施麻醉手术。记录患者术后AKI及术后其他相关并发症(肺部感染、脓毒症、脑梗死)发生情况。结果:与Ⅱ组相比,Ⅰ组术后AKI发生率升高(P<0.05),相对危险度为3.2(95%置信区间为1.31~7.70),肺部感染、脓毒症和脑梗死发生率差异无统计学意义(P>0.05)。结论:生物节律因素影响体外循环心脏手术后AKI发生,下午较上午实施手术有助于降低术后AKI发生。ObjectiveTo evaluate the effects of biorhythm factors on the occurrence of acute kidney injury(AKI)after cardiac surgery using cardiopulmonary bypass.MethodsThis was a retrospective cohort study.Data from patients undergoing heart surgery involving cardiopulmonary bypass from June 2018 to December 2019 were collected and divided into 2 groups(n=125 each)based on the time of anesthesia operation:morning rhythm group(groupⅠ)and afternoon rhythm group(groupⅡ).Anesthesia operation was performed from 8:00 to 12:00 in groupⅠ.Anesthesia was performed from 14:00 to 18:00 in groupⅡ.The occurrence of postoperative AKI and other postoperative complications(pulmonary infection,sepsis,cerebral infarction)was recorded.ResultsCompared with groupⅡ,the incidence of postoperative AKI was significantly increased,the relative risk was 3.2(95%confidence interval 1.31-7.70),and no significant change was found in the incidence of pulmonary infection,sepsis and cerebral infarction in groupⅠ(P>0.05).ConclusionsBiorhythm factors affect the development of AKI after cardiac surgery using cardiopulmonary bypass,and performing surgeries in the afternoon rather than the morning helps reduce the risk of postoperative AKI.

关 键 词：生物节律 体外循环 急性肾损伤 队列研究 心脏手术 

分 类 号：R614[医药卫生—麻醉学]