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目的探讨心脏病患者术后并发急性肾损伤行连续性肾脏替代治疗死亡的危险因素?方法选取2011年2月—2016年2月行心脏手术后发生急性肾损伤的患者65例,根据患者转归结局分为存活组(29例),死亡组(36例)。患者均给予连续性肾脏替代治疗,收集患者一般资料。计量资料比较采用t检验,计数资料比较采用χ2检验,采用多因素Logistic回归分析死亡危险因素。P<0.05为差异有统计学意义。结果存活组术后到连续性肾脏替代治疗时间(3.1±2.9)d、血白蛋白(110.8±25.2)g/L、血红蛋白(21.4±8.7)U/L;死亡组术后到连续性肾脏替代治疗时间(6.8±1.5)d、血白蛋白(128.4±16.8)g/L、血红蛋白(39.1±11.4)U/L。两组术后到连续性肾脏替代治疗时间、血白蛋白、血红蛋白比较差异有统计学意义(均P<0.05),其余资料比较差异无统计学意义(均P>0.05)。血白蛋白水平及术前心功能分级是患者死亡的危险因素(OR=0.89、3.70,均P<0.05)。结论心脏手术患者术后因急性肾损伤接受连续性肾脏替代治疗后病死率较高,患者手术前后血白蛋白水平及术前心功能分级为患者死亡的独立危险因素。
Objective To investigate the risk factors of death after continuous renal replacement therapy in patients with acute heart injury after cardiac surgery. Methods Sixty-five patients with acute kidney injury after cardiac surgery from February 2011 to February 2016 were enrolled in this study. Bureau divided into survival group (29 cases), death group (36 cases). Patients were given continuous renal replacement therapy, the general data collected. Measurement data were compared using t test, count data were compared using χ2 test, using multivariate Logistic regression analysis of risk factors for death. P <0.05 for the difference was statistically significant. Results The duration of postoperative continuous renal replacement therapy was (3.1 ± 2.9) d, and the serum albumin (110.8 ± 25.2) g / L and hemoglobin (21.4 ± 8.7) U / Treatment time (6.8 ± 1.5) d, serum albumin (128.4 ± 16.8) g / L, hemoglobin (39.1 ± 11.4) U / L. There were significant differences in serum albumin and hemoglobin between the two groups (all P <0.05). There was no significant difference in other data (all P> 0.05). Serum albumin levels and preoperative heart function grading were risk factors for death (OR = 0.89, 3.70, all P <0.05). Conclusion The postoperative mortality of patients undergoing cardiac surgery after continuous renal replacement therapy for acute kidney injury is high. Preoperative and postoperative serum albumin levels and preoperative cardiac function are independent risk factors for death.