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外科动脉置换和功能障碍:从急性损伤到慢性疾病

Antonio Lacquaniti¹, Fabrizio Ceresa², Susanna Campo¹

¹Nephrology and Dialysis Unit, Department of Internal Medicine, Papardo Hospital, 98158 Messina, Italy.

Journal of clinical medicine

|May 25, 2024

概括

急性损伤 (AKI) 是大动脉置换手术 (SAVR) 后的一个常见并发症. 预先存在的严重慢性病 (CKD) 是患上外科手术后AKI的重要危险因素.

科学领域:

腎臟病學 (nephrology) 是一種醫學專業.
心血管外科心血管外科
关键护理医学关键护理医学

背景情况:

手术性大动脉置换 (SAVR) 经常与急性损伤 (AKI) 相关.
早期识别患有AKI风险的患者对于实施脏保护措施或脏替代疗法 (RRT) 至关重要.
这项研究研究了SAVR患者手术后AKI的发生率和危险因素,包括手术后慢性病 (CKD) 的发展.

研究的目的:

在接受SAVR的患者中调查术后AKI的发生率和危险因素.
在心脏手术后的随访期间评估CKD的发展.
确定AKI的预测因素及其对患者结果的影响.

主要方法:

对接受SAVR的462名患者进行了回顾性分析.
主要终点:手术后AKI的发生率.
在手术后12个月内通过门诊科访问评估的恢复.

主要成果:

76名患者 (16.5%) 经历了AKI事件.
卡普兰-梅尔分析显示,与IV阶段相比,CKD I-II阶段的患者的进展显著减缓.
考克斯回归确定了CKD阶段作为AKI的独立预测因素;严重的手术前CKD与术后死亡率相关.

结论:

AKI是SAVR后的常见并发症,导致长时间的ICU停留和减少生存率,特别是当需要RRT时.
手术前的CKD阶段>3是SAVR患者发展AKI的独立风险因素.
在随访期间,AKI可能导致预先存在的CKD恶化.

关键词:

AKI 到 CKD 的过渡急性脏损伤急性脏损伤的恢复的恢复替代疗法是一种替代疗法.外科门更换 (SAVR) 的方法

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