摘要
目的 分析老年患者胃癌根治术后急性肾损伤(AKI)的危险因素.方法 回顾性收集接受胃癌根治手术老年患者691例的临床资料,男563例,女128例,年龄≥65岁,ASA Ⅰ-Ⅲ级.临床资料包括性别、年龄、体重、BMI、ASA分级、吸烟及饮酒史、术前合并症、手术时间、术中用药情况、术中液体出入量、术中尿量、术后住院时间、总住院时间等.根据患者术后是否发生AKI分为两组:AKI组和非AKI组.采用多因素Logistic回归分析发生术后AKI的危险因素.结果 有16例(2.3％)患者发生术后AKI.多因素Logistic回归分析结果显示,合并冠心病(OR=5.587,95％CI 1.355～23.029,P=0.017)和术中尿量减少(OR=0.997,95％CI 0.995～1.000,P=0.023)是老年患者胃癌根治术后AKI的独立危险因素.结论 术前合并冠心病及术中尿量减少是老年胃癌根治术患者术后发生AKI的独立危险因素.
Abstract
Objective To analyse the risk factors of acute kidney injury(AKI)in elderly patients undergoing gastrectomy for gastric cancer.Methods The clinical data of 691 elderly patients,563 males and 128 females,aged ≥ 65 years,ASA physical grade Ⅰ to Ⅲ,who with gastrectomy for gastric cancer were retrospectively analyzed.Clinical data collected included sex,age,body weight,BMI,ASA physical status,preoperative comorbidities,history of alcohol and smoking history,operation duration,use of drugs,fluid intake and output,urine output,postoperative length of stay,total cost of hospitalization,and so on.According to the occurrence of AKI,the patients were divided into two groups:AKI group and non-AKI group.Multivariable logistic regression was used to determine the risk factors for AKI.Results Sixteen pa-tients(2.3％)developed AKI.Multivariate logistic regression showed that coronary heart disease(OR=5.587,95％CI 1.355-23.029,P=0.017)and lower urine output(OR=0.997,95％CI 0.995-1.000,P=0.023)were independent risk factors of AKI in aged patients.Conclusion Coronary heart disease and lower urine output were independent risk factors of AKI in elderly patients undergoing gastrecto-my.
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