肺切除手术后急性损伤的预测因素:一个回顾性病例对照研究
Ethan Bohn1, Sadeesh Srinathan2, Joel Adu-Quaye1
1Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba, 2nd Floor Harry Medovy House, 671 William Avenue, Winnipeg, MB, R3E 0Z2, Canada.
Canadian journal of anaesthesia = Journal canadien d'anesthesie
|October 26, 2023
概括
急性损伤 (AKI) 在肺切除手术后很常见. 关键的风险因素包括更长的单肺通风 (OLV) 持续时间,手术前肌素,男性性别和ARB使用.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 胸部外科手术 胸部外科手术
- 关键护理医学 关键护理医学
背景情况:
- 接受肺切除的患者面临术后急性损伤 (AKI) 的风险增加.
- 肺切除后的AKI对长期的发病率和死亡率有重大影响.
- 在这个手术患者群体中,AKI的特定风险因素仍未得到充分研究.
研究的目的:
- 在肺切除手术后的患者中确定早期发病AKI的独立风险因素.
主要方法:
- 进行了一项追溯病例控制研究,涉及接受选择性肺切除的患者.
- 使用KDIGO标准来定义AKI;对照没有AKI.
- 多变量后勤回归分析了人口统计,并发症,肺切除体积和单肺通风 (OLV) 持续时间.
主要成果:
- 在48小时内发生AKI的发病率为5.5% (57/1,045名患者).
- 独立预测AKI的因素包括手术前血清肌水平升高,男性性别,血管激素II受体阻断剂的使用,以及OLV的持续时间.
- AKI与更高的并发症率,ICU入院率和死亡率有关.
结论:
- 急性损伤是肺切除后经常出现的并发症.
- 长时间的单肺通风 (OLV) 似乎是该患者群体中AKI的潜在危险因素.
- 识别和减轻这些风险因素对于改善患者的治疗结果至关重要.
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