在进行肝移植的患者中进行手术内正常的盐水注射和急性损伤
Ji-Yoon Jung1, Jae-Woo Ju1, Hyun-Kyu Yoon1
1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Transplantation proceedings
|February 27, 2024
概括
在活体供体肝移植 (LDLT) 期间,正常的盐水管理增加了急性损伤 (AKI) 的风险,并与平衡的晶体化物相比,延长了住院时间. 这一发现凸显了移植患者选择液体的潜在风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植手术 移植手术
- 临界护理医学 临界护理医学
背景情况:
- 正常的盐水经常用于活体供体肝移植 (LDLT),用于正常水平的患者.
- 在LDLT患者中,正常盐水和急性损伤 (AKI) 之间的潜在关联仍然令人担忧.
研究的目的:
- 为了研究在LDLT期间正常的盐水给药是否会增加与平衡晶状体相比的AKI风险.
- 评估液体选择对LDLT接受者的术后结果的影响.
主要方法:
- 对1011个LDLT病例进行了回顾性审查.
- 倾向性得分匹配和治疗权重的逆概率 (IPTW) 用于比较正常盐水和平衡晶体组之间的AKI风险.
- 进行了顺序逻辑回归分析,以评估盐水和AKI之间的关联.
主要成果:
- 在正常盐水组中,AKI的发病率明显高 (50.6%),相比于在匹配后的平衡晶体组 (38.5%) (P = .010).
- 严重的AKI (第二或第三阶段) 在盐水组中也更频繁 (14.9%对24.7%,P = .022).
- 接受正常盐水的患者经历了更长的住院时间和与AKI风险的显著关联 (OR 1.23,P = .013).
结论:
- 在LDLT期间正常使用盐水与术后AKI和延长住院的风险增加有关.
- 这些发现表明,平衡的晶体合物可能是LDLT患者更安全的液体选择.
- 由于数据收集时间延长,建议进一步谨慎解释.
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