大型选择性腹部手术后急性损伤的危险因素:一项前性观察性研究
Dilan Buyuk1, Esin A Sonmez2, Demet A Bingol3
1Department of Anesthesiology and Reanimation, Private Anatolia Hospital Lara, Antalya, Turkey.
Saudi journal of anaesthesia
|September 25, 2025
概括
大型腹部手术后急性损伤的发生率为11.52%. 关键的风险因素包括血管压缩剂的使用,低平均动脉压,基乙烯粉的使用和高的BMI,需要密切监测和风险因素的修改.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 外科手术的结果
- 临界护理医学 临界护理医学
背景情况:
- 急性损伤 (AKI) 是一次重大腹部手术后的严重并发症.
- 确定AKI的术后发病率和风险因素对于患者管理至关重要.
研究的目的:
- 为了确定急性损伤 (AKI) 在选择性腹部大手术后的发生率.
- 确定与AKI发展相关的独立风险因素.
主要方法:
- 一项前性观察性研究,包括接受选择性主要腹部手术的成年患者.
- 根据KDIGO标准,患者在48小时后被分为AKI+和AKI组.
- 收集的数据包括人口统计,术前状态,术后细节和术后结果,随访3个月.
主要成果:
- AKI的发生率为11.52% (49/425名患者).
- 独立的AKI风险因素是术后使用血管压缩剂 (OR 5.1),平均动脉压<50 mmHg (OR 3.9),手术期间使用6%的基乙烯粉 (HES) (OR 2.7) 和高体重指数 (OR 1.2).
- 在患有AKI的患者中观察到更高的30日和90天死亡率.
结论:
- 大型腹部手术后的术后AKI与显著的死亡率有关.
- 建议避免6%的高血压和密切的血压监测等可修改的风险因素来减少AKI的发生率.
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