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| 高血压脑出血术后急性肾损伤相关危险因素分析 |
| Related risk factor analysis of postoperative acute kidney injury in hypertensive intracerebral hemorrhage patients |
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| DOI：10.12089/jca.2018.10.005 |
| 中文关键词: 急性肾损伤 危险因素 脑出血 高血压 手术 |
| 英文关键词: Acute kidney injury Risk factors Intracerebral hemorrhage Hypertension Operation |
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| 中文摘要: |
目的 通过病例对照研究,分析发生高血压脑出血术后急性肾损伤(acute kidney injury,AKI)的相关危险因素。
方法 选择2014年11月1日至2017年2月28日高血压脑出血接受外科手术治疗的患者211例,男139例,女72例,年龄28～86岁,根据术后是否发生AKI分为两组：AKI组和非AKI组。统计术后AKI发生率、术后30 d全因死亡率及GOS评分、ICU留观时间、住院时间和住院费用。采用Logistic回归分析术后发生AKI的相关危险因素。
结果 术后发生AKI 38例，AKI发生率为18％;与非AKI组比较,AKI组术后7 d全因死亡率明显升高(P<0.01)，术后30 d全因死亡率明显升高(P<0.01)，术后30 d GOS评分明显降低（P<0.01)，术后ICU留观时间明显延长(P<0.01);两组住院时间、住院费用差异无统计学意义。多因素Logistic回归分析
结果 显示,术中输血(OR=13.98,95％CI 4.23～46.17,P<0.01)和术中使用甘露醇(OR=3.55,95％CI 1.60～7.89,P<0.01)是高血压脑出血术后AKI的独立危险因素。
结论 高血压脑出血术后AKI的发生率为18％,术中输血和使用甘露醇可能是高血压脑出血术后发生AKI的独立危险因素,并且术后AKI患者术后7 d及30 d全因死亡率明显升高。 |
| 英文摘要: |
Objective To observe the incidence of postoperative acute kidney injury in hypertensive intracerebral hemorrhage patients through case-control study, and to analyze the related risk factors.
Methods A total of 211 hypertensive intracerebral hemorrhage patients who received operation from November 1st, 2014 to February 28th, 2017, 139 males and 72 females, aged 28 - 86 years, were retrospectively analyzed. According to the fact whether postoperative acute kidney injury happend, these patients were divided into acute kidney injury group (AKI) and non-acute kidney injury group (nAKI), and the incidence of postoperative acute kidney injury, the postoperative 30-day all-cause mortality, the postoperative 30-day glasgow outcome score, length of ICU stay, hospital stay and hospital cost were calculated. Logistic regression analysis was used to analyze the risk factors of postoperative acute kidney injury.
Results The incidence of postoperative AKI was 18％ (38/211). Compared with the non-AKI group, the 7-day all-cause mortality was higher in the AKI group (P < 0.01), the 30-day all-cause mortality was also higher (P < 0.01), the postoperative 30-day GOS was decreased (P < 0.01), thus the length of ICU stay was prolonged (P < 0.01). There was no statistically significant difference in the length of hospital stay and the hospital cost between the two groups. Logistic multivariate regression analysis showed that the intraoperative blood transfusion (OR = 13.98, 95％ CI 4.23 - 46.17, P < 0.01) and use of mannitol (OR = 3.55, 95％ CI 1.60 - 7.89, P < 0.01) were the independent risk factors for postoperative acute kidney injury in hypertensive intracerebral hemorrhage patients.
Conclusion The incidence of postoperative acute kidney injury in hypertensive intracerebral hemorrhage patients is 18％. Intraoperative blood transfusion and the use of mannitol may be the independent risk factors for postoperative acute kidney injury in hypertensive intracerebral hemorrhage patients. Thus, both the postoperative 7-day and 30-day all-cause mortality rate are significantly higher in the AKI patients. |
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