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| 食管癌根治术中肾脏氧饱和度与术后肾功能异常的相关性 |
| Correlation between renal oxygen saturation during radical resection of esophageal carcinoma and postoperative renal dysfunction |
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| DOI：10.12089/jca.2023.05.013 |
| 中文关键词: 食管癌根治术 近红外光谱技术 区域组织氧饱和度 肾功能异常 |
| 英文关键词: Radical resection of esophageal carcinoma Near infrared spectroscopy Regional oxygen saturation Renal dysfunction |
| 基金项目:江苏省肿瘤医院优才基金（YC201805） |
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| 中文摘要: |
目的 探讨食管癌根治术中肾脏区域组织氧饱和度（rSO2）与术后肾功能异常的相关性。
方法 选择拟行食管癌根治术的患者116例，男93例，女23例，年龄18～64岁，BMI＜24 kg/m2，ASA Ⅱ或Ⅲ级。术中连续监测左侧肾脏rSO2。设定麻醉诱导后肾脏rSO2为基础值，当术中肾脏rSO2绝对值≤50%或低于基础值的75%时，定义为肾脏rSO2异常下降。记录术前及术后24 h尿素氮（BUN）、血清肌酐（SCr），术后肾功能异常定义为术后24 h血浆SCr＞130 μmol/L或BUN＞7.5 mmol/L。根据术后是否出现肾功能异常将患者分为两组：肾功能正常组和肾功能异常组。采用列联系数分析术中肾脏rSO2异常下降与术后肾功能异常的相关性。
结果 有40例（34.5%）患者术中出现肾脏rSO2异常下降，有45例（38.8%）患者术后出现肾功能异常。二元Logistic回归分析显示男性是术后肾功能异常的危险因素（OR=5.490，95%CI 1.526～19.754，P=0.009）。食管癌根治术中肾脏rSO2的异常下降与术后肾脏功能异常呈正相关（rs=0.587，P=0.009)。
结论 食管癌根治术中肾脏rSO2异常下降与术后肾功能异常呈正相关。 |
| 英文摘要: |
Objective To investigate correlation between regional renal tissue oxygen saturation (rSO2) and postoperative renal dysfunction during radical resection of esophageal carcinoma.
Methods A total of 116 patients undergoing radical resection of esophageal carcinoma, 93 males and 23 females, aged 18-64 years, BMI < 24 kg/m2, ASA physical status Ⅱ or Ⅲ, were selected. The value of renal rSO2 after anesthesia induction was set as the base value. When the absolute value of renal rSO2 during operation was less than 50% or less than 75% of the base value, the patient was considered as abnormal decrease of renal rSO2. Blood urea nitrogen (BUN) and serum creatinine (SCr) were recorded before operation and 24 hours after operation. SCr > 130 μmol/L or BUN > 7.5 mmol/L was considered as postoperative renal dysfunction 24 hours after operation. Patients were divided into two groups according to postoperative renal dysfunction occured: the normal renal function group and the abnormal renal function group. Contingency coefficient was used to analyze the correlation between abnormal decrease of renal rSO2 during operation and abnormal renal function after operation.
Results During the operation, forty patients (34.5%) had abnormal renal tissue oxygen saturation. After operation, forty-five patients (38.8%) had postoperative renal dysfunction. Binary Logistic regression analysis showed that male was a risk factor for postoperative renal dysfunction (OR = 5.490, 95% CI 1.526-19.754, P = 0.009). The abnormal decrease of renal rSO2 during radical resection of esophageal cancer was positively correlated with postoperative renal dysfunction (rs = 0.587, P = 0.009).
Conclusion Abnormal decrease of renal rSO2 during radical resection of esophageal cancer is positively correlated with abnormal renal function after operation. |
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