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脑肿瘤患者术中低血压与术后急性肾损伤的相关性

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目的 探讨脑肿瘤切除术中低血压与术后急性肾损伤(AKI)的相关性.方法 筛选择期行脑肿瘤切除术的患者 428 例,男276例,女152例,年龄≥18岁,BMI 15~36 kg/m2,ASA Ⅱ或Ⅲ级.根据术后是否发生AKI将患者分为两组:AKI组和非AKI组.本研究定义了3个低血压阈值,分别为术中MAP<65 mmHg、60 mmHg和55 mmHg,采用多因素Logistic回归分析3 个不同阈值下术中低血压与术后AKI的相关性.结果 共有107例发生术后AKI.多因素回归分析结果显示,术中MAP<65 mmHg(OR=1.11,95%CI 1.03~1.20,P=0.010)和术中MAP<60 mmHg(OR=1.12,95%CI 1.02~1.23,P=0.017)与术后AKI的发生相关.结论 术中MAP<65 mmHg和 60 mmHg与脑肿瘤切除术后AKI的发生相关.
Association between intraoperative hypotension and postoperative acute kidney injury in patients un-dergoing brain tumor resection
Objective To investigate the association between intraoperative hypotension and post-operative acute kidney injury(AKI)in patients undergoing brain tumor resections.Methods A total of 428 patients undergoing elective craniotomy for tumor resection were selected,276 males and 152 females,aged≥18 years,BMI 15-36 kg/m2,ASA physical statusⅡ orⅢ.Based on postoperative occurrence of AKI,the patients were divided into two groups:the AKI group and the control group.This study defined three thresholds for hypotension,including MAP during surgery below 65 mmHg,60 mmHg,and 55 mmHg.Multivariate logistic regression was used to analyze the correlation between intraoperative hypotension and postoperative AKI under three thresholds.Results A total of 107 patients had postoperative AKI.The re-sults of multivariable regression analysis indicated that intraoperative MAP<65 mmHg(OR = 1.11,95%CI 1.03-1.20,P = 0.010)and intraoperative MAP<60 mmHg(OR = 1.12,95%CI 1.02-1.23,P = 0.017)were associated with postoperative AKI.Conclusion Intraoperative MAP<65 mmHg or 60 mmHg is associated with postoperative AKI in patients undergoing brain tumor resection.

Acute kidney injuryBrain tumorIntraoperative hypotension

崔倩宇、李嘉欣、马婷婷、张星月、李姝、曾敏、彭宇明

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100070 首都医科大学附属北京天坛医院麻醉科

北京大学人民医院麻醉科

首都医科大学附属北京安贞医院麻醉科

首都医科大学宣武医院麻醉科

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急性肾损伤 脑肿瘤 术中低血压

国家重点研发项目北京市科学技术委员会项目

2018YFC2001901Z191100006619068

2024

临床麻醉学杂志
中华医学会南京分会

临床麻醉学杂志

CSTPCD北大核心
影响因子:2.225
ISSN:1004-5805
年,卷(期):2024.40(2)
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