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OPCABG术后急性肾损伤的危险因素分析

桂雷,陈庆良   

  1. 天津市胸科医院
  • 收稿日期:2011-10-14 修回日期:2011-11-10 出版日期:2012-02-15 发布日期:2012-02-15
  • 通讯作者: 陈庆良

Analysis of the risk factors of acute renal injury after off-pump coronary artery bypass grafting

  • Received:2011-10-14 Revised:2011-11-10 Published:2012-02-15 Online:2012-02-15

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摘要： 探讨非体外循环冠状动脉旁路移植术(OPCABG)后急性肾功能损伤(AKI)的发生率及危险因素。方法:回顾性分析我院2009年6月到2009年12月完成的537例OPCABG手术患者的临床资料。根据国内有关AKI的诊断标准,将患者分为AKI组和对照组,统计术后AKI的发生率并对其危险因素进行分析。结果:537例患者OPCABG术后AKI的发生率是14.7％(79/537)。单因素分析显示: 年龄≥70岁、高血压、术前肌酐水平、移植血管桥数量、机械通气时间、监护室停留时间及术后低心排等因素在两组间差异有统计学意义。logistic多因素回归分析提示年龄≥70岁、高血压、术前肌酐水平、移植血管桥数量、机械通气时间及术后低心排，是OPCABG术后AKI的独立危险因素。结论:AKI是OPCABG术后较常见和严重的术后并发症， 应引起临床高度重视。年龄≥70岁、高血压、术前肌酐水平、移植血管桥数量、机械通气时间及术后低心排，是OPCABG术后AKI发生的独立危险因素

关键词: 冠状动脉旁路移植术, 肾功能衰竭, 急性, 危险因素, 非体外循环

Abstract: to study the incidence and risk factors after off-pump coronary bypass grafting(OPCABG). Methods: the clinical data of 537 patients of our hospital undertaking OPCABG between June 2009 and December 2009 were retrospectively analyzed. According to the relevant domestic AKI diagnostic criteria, divided the patients into AKI group with AKI and control group without AKI, the incidence and the risk factors of postoperative AKI were counted and analyzed. Results: AKI with an incidence of 14.7 % (79/537) occurred in 537 patients. Single factor analysis showed that there were significant statistics differences among advanced age, hypertension ,preoperative serum creatinine, number of grafts, mechanical ventilation time，ICU time and postoperative low heart output. Logistic multi-factor regression analysis showed that advanced age, hypertension, preoperative serum creatinine, number of grafts , mechanical ventilation time and postoperative low heart output were independent risk factors of AKI. Conclusion: AKI was one of the most common and serious complications after OPCABG, which should cause clinical high attention. Advanced age, hypertension, preoperative serum creatinine, number of grafts, mechanical ventilation time and postoperative low heart output were independent risk factors of AKI.

Key words: Coronary artery bypass grafting, Renal failure, Acute, Risk factors, off-pump cardiopulmonary bypass