|本期目录/Table of Contents|

[1]孔 媛,于泳浩.全凭静脉麻醉下神经外科手术急性肾损伤高危因素回顾性分析[J].天津医科大学学报,2018,24(01):47-49.
　KONG Yuan,YU Yong-hao.Retrospective analysis of high risk factors for acute renal injury in neurosurgical patients under total intravenous anesthesia[J].Journal of Tianjin Medical University,2018,24(01):47-49.
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
24卷
期数:
2018年01期
页码:
47-49
栏目:
临床医学
出版日期:
2018-01-20

文章信息/Info

Title:
Retrospective analysis of high risk factors for acute renal injury in neurosurgical patients under total intravenous anesthesia
文章编号:
1006-8147(2018)01-0047-03
作者:
孔 媛1; 2 ;  于泳浩2
（1．天津医科大学研究生院，天津 300070； 2 .天津医科大学总医院麻醉科, 天津 300052）
Author(s):
KONG Yuan1; 2 ;  YU Yong-hao2
(1.Graduate School ， Tianjin Medical University, Tianjin 300070,China ；2.Department of Anesthesiology, General Hospital ,Tianjin Medical University, Tianjin 300052,China)
关键词:
全凭静脉麻醉; 神经外科手术; 急性肾损伤 ; 危险因素
Keywords:
total intravenous anesthesia;  neurosurgery;  acute kidney injury;  risk factors
分类号:
R614
DOI:
-
文献标志码:
A
摘要:
目的： 回顾性分析全凭静脉麻醉下神经外科手术急性肾损伤发生的高危因素。 方法 ：选择200例神经外科手术患者的临床资料，根据是否发生急性肾损伤分为并发急性肾损伤组 （阳性组）17例和未并发急性肾损伤组（对照组）183例。研究患者发生急性肾损伤的危险因素。结果 ：患者术后尿素、术后肌酐、术前尿酸、术后尿酸、术中动脉血乳酸值、入室GCS评分、术前肾小球滤过率较对照组差异有统计学意义（P<0.05）。Logistic 回归分析显示，术中动脉血乳酸值、术前肾小球滤过率与神经外科手术并发急性肾损伤独立相关。结论： 术中动脉血乳酸值及术前肾小球滤过率是导致神经外科手术患者在全凭静脉麻醉下并发急性肾损伤的独立危险因素，为神经外科手术围术期肾损伤的预防和治疗提供参考依据。
Abstract:
Objective ：To explore the risk factors for acute kidney injury (AKI) in neurosurgical patients. Methods ：Clinical data of 200 neurosurgery patients were retrospectively observed. Patients were divided into experimental group (acute renal injury group, 17 cases) and control group (183 cases). The risk of acute kidney injury in patients was analyzed. Results ：The postoperative urea, creatinine, uric acid,postoperative urea acid, preoperative arterial blood lactic acid, preoperative GCS score, preoperative glomerular filtration rate in the experimental group showed statistically significant differences (P < 0. 05) in comparison with control group. Logistic regression analysis showed that intraoperative blood lactic acid value and preoperative glomerular filtration rate were independently associated with AKI in neurosurgical patients. Conclusion ：Arterial blood lactic acid value and preoperative glomerular filtration rate are independent risk factors of AKI in neurosurgical patients. The results provide support for the prevention and treatment of perioperative renal injury in neurosurgical patients.

参考文献/References:

[1]Corral L, Javierre C F, Ventura J L, et al. Impact of non-neurosurgical complications in severe traumatic brain injury outcome[ J]. Crit Care, 2012, 16: R44

[2]Ahmed M, Sriganesh K, Vinay B, et al. Acute kidney injury in survivors of surgery for severe traumatic brain injury: incidence, risk factors, and outcome from a tertiary neuroscience center in India[ J]. Br J Neurosurg, 2015, 29: 544

[3]Hess D C, Blauenfeldt R A, Andersen G, et al. Remote ischaemic conditioning-a new paradigm of self-protection in the brain[ J]. Nat Rev Neurol, 2015， 11(12): p698

[4]Luo X, Jiang L, Du B, et al. A comparison of different diagnostic criteria of acute kidney injury in critically ill patients[ J]. Crit Care, 2014, 18:144

[5]Khwaja A. KDIGO clinical practice guidelines for acute kidney injury [J].Nephron Clin Pract ，2012，120:c179

[6]Barasch J, Zager R, Bonventre J V. Acute kidney injury: a problem of definition[ J]. Lancet, 2017， 389:779

[7]Bagshaw S M, George C, Gibney R T, et al. A multi-center evaluation of early acute kidney injury in critically ill trauma patients[ J]. Ren Fail, 2008, 30(6): 58l

[8]Yates R B ，Sheng H ，Sakai H ，et al. Lack of evidence for a remote effect of renal ischemia／reperfusion acute kidney injury on outcome from temporary focal cerebral ischemia in the rat［J ］ ．J Cardiothorac Vasc Anesth ，2013,27（1）:71

[9]Ono M , Amaoutakis G J , Fine D M ，et al. Blood pressure excursions below the cerebral autoregulation threshold during cardiac surgery are associated with acute kidney injury［J］.Crit Care Med ，2013,41（2）：464

[10]Yoo D J , Agodoa L , Yuan C M , et al. Risk of intracranial hemorrhage associated with autosomal dominant polycystic kidney disease in patients with end stage renal disease［J］.BMC Nephrol ，2014,15(1):39

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备注/Memo

备注/Memo:
作者简介 孔媛（1987-），女，硕士在读，研究方向：全凭静脉麻醉；通信作者：于泳浩，E-mail：yuyonghao@126.com。
更新日期/Last Update: 2018-01-19