文章摘要
老年患者胃癌根治术后急性肾损伤的危险因素
Risk factors of postoperative acute kidney injury in elderly patients undergoing radical gastrectomy
  
DOI：10.12089/jca.2024.03.004
中文关键词: 老年  胃癌根治术  急性肾损伤  少尿  冠心病
英文关键词: Aged  Radical gastrectomy  Acute kidney injury  Oliguria  Coronary heart disease
基金项目:国家重点研发计划（2018YFC2001901）
作者单位E-mail
崔银 210008,南京大学医学院附属鼓楼医院麻醉科  
吴玉慧 210008,南京大学医学院附属鼓楼医院麻醉科  
马正良 210008,南京大学医学院附属鼓楼医院麻醉科  
顾小萍 210008,南京大学医学院附属鼓楼医院麻醉科 xiaopinggu@nju.edu.cn 
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中文摘要:
      
目的：分析老年患者胃癌根治术后急性肾损伤（AKI）的危险因素。
方法：回顾性收集接受胃癌根治手术老年患者691例的临床资料，男563例，女128例，年龄≥65岁，ASA Ⅰ—Ⅲ级。临床资料包括性别、年龄、体重、BMI、ASA分级、吸烟及饮酒史、术前合并症、手术时间、术中用药情况、术中液体出入量、术中尿量、术后住院时间、总住院时间等。根据患者术后是否发生AKI分为两组：AKI组和非AKI组。采用多因素Logistic回归分析发生术后AKI的危险因素。
结果：有16例（2.3%）患者发生术后AKI。多因素Logistic回归分析结果显示，合并冠心病（OR=5.587，95%CI 1.355～23.029，P=0.017）和术中尿量减少（OR=0.997，95%CI 0.995～1.000，P=0.023）是老年患者胃癌根治术后AKI的独立危险因素。
结论：术前合并冠心病及术中尿量减少是老年胃癌根治术患者术后发生AKI的独立危险因素。
英文摘要:
      
Objective: To analyse the risk factors of acute kidney injury (AKI) in elderly patients undergoing gastrectomy for gastric cancer.
Methods: The clinical data of 691 elderly patients, 563 males and 128 females, aged ≥ 65 years, ASA physical grade Ⅰ to Ⅲ, who with gastrectomy for gastric cancer were retrospectively analyzed. Clinical data collected included sex, age, body weight, BMI, ASA physical status, preoperative comorbidities, history of alcohol and smoking history, operation duration, use of drugs, fluid intake and output, urine output, postoperative length of stay, total cost of hospitalization, and so on. According to the occurrence of AKI, the patients were divided into two groups: AKI group and non-AKI group. Multivariable logistic regression was used to determine the risk factors for AKI.
Results: Sixteen patients (2.3%) developed AKI. Multivariate logistic regression showed that coronary heart disease (OR = 5.587, 95% CI 1.355-23.029, P = 0.017) and lower urine output (OR = 0.997, 95% CI 0.995-1.000, P = 0.023) were independent risk factors of AKI in aged patients.
Conclusion: Coronary heart disease and lower urine output were independent risk factors of AKI in elderly patients undergoing gastrectomy.
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