严重外伤患者术后急性肾损伤发生风险因素  

Risk factors of postoperative acute kidney injury in patients with severe trauma

作　　者：阙献琴 QUE Xianqin(Lishui Central Hospital,Zhejiang 323000,China)

机构地区：[1]浙江省丽水市中心医院,丽水323600

出　　处：《浙江创伤外科》2024年第12期2207-2209,共3页Zhejiang Journal of Traumatic Surgery

摘　　要：目的探讨严重外伤患者术后急性肾损伤发生风险因素,旨在为后续临床防治工作提供参考。方法回顾性纳入2022年1月至2023年12月于本院行手术治疗严重外伤患者共108例,根据术后是否发生急性肾损伤分为急性肾损伤组(20例)和无急性肾损伤组(88例);比较两组临床特征资料,依据Logistics回归模型评估严重外伤患者术后急性肾损伤发生独立危险因素。结果单因素分析结果显示,是否合并休克、是否使用造影剂、甘露醇用量、晶体液输注量、DAVROS评分及MEWS评分均可能与严重外伤患者术后急性肾损伤发生有关(P<0.05);多因素分析结果显示,合并休克、使用造影剂、晶体液输注量≥4 L/d、更高DAVROS评分及更高MEWS评分均是严重外伤患者术后急性肾损伤发生独立危险因素(P<0.05)。结论严重外伤患者如合并休克、使用造影剂、晶体液输注量≥4 L/d、DAVROS评分及MEWS评分更高则术后急性肾损伤发生风险显著升高。Objective To investigate the risk factors of postoperative acute kidney injury in patients with severe trauma to provide reference for follow-up clinical prevention and treatment.Methods 108 patients with severe trauma who underwent surgery in our hospital from January 2022 to December 2023 were retrospectively included and were divided into acute kidney injury group(n=20)and non-acute kidney injury group(n=88)according to whether acute kidney injury occurred after surgery.The clinical characteristics of the two groups were compared,and the independent risk factors of postoperative acute kidney injury in patients with severe trauma were evaluated according to Logistics regression model.Results The results of univariate analysis showed that the combination of shock,the use of contrast media,the dosage of mannitol,the infusion amount of crystal solution,DAVROS score and MEWS score were related to the occurrence of postoperative acute kidney injury in patients with severe trauma(P<0.05).Multivariate analysis showed that the combined shock,use of contrast media,infusion volume of crystal fluid≥4 L/d,higher DAVROS score and higher MEWS score were independent risk factors for postoperative acute kidney injury in patients with severe trauma(P<0.05).Conclusion The risk of postoperative acute kidney injury was significantly increased in patients with severe trauma,such as shock,use of contrast media,infusion volume of crystal fluid≥4 L/d,DAVROS score and MEWS score were higher.

关 键 词：严重外伤 手术 急性肾损伤 危险因素 

分 类 号：R459.7[医药卫生—急诊医学]