摘要
Abstract
Objective:To analyze the occurrence and influencing factors of postoperative acute kidney injury(POAKI)after prophylactic ileostomy in patients with rectal cancer.Method:The clinical data of 302 patients with rectal cancer in the First Affiliated Hospital of Soochow University were retrospectively analyzed from January 2021 to December 2023.All patients received radical resection of rectal cancer and prophylactic ileostomy.According to the occurrence of POAKI,the patients were divided into control group and POAKI group.The general clinical data such as age,gender,body mass index,hypertension and diabetes mellitus and clinical characteristics such as American Society of Anesthesiologists(ASA)grading,surgical time,intraoperative blood loss,presence or absence of preoperative neoadjuvant therapy,postoperative daily ostomy discharge,presence or absence of postoperative anastomotic fistula leakage and presence or absence of postoperative gastrointestinal motility drugs were compared between the two groups.logistic regression analysis was used to analyze the influencing factors of acute kidney injury after prophylactic ileostomy in patients with colorectal cancer.Result:Among the 302 patients receiving radical resection of rectal cancer and prophylactic terminal ileostomy,48 patients had POAKI,with an incidence rate of 15.89%,and they had improved renal function after conservative treatment,and no patient had chronic renal failure secondary to severe renal function injury.There were no statistical differences in gender,age,body mass index,hypertension,ASA grading,surgical time and application of gastrointestinal motility drugs between groups(P>0.05).The incidence of diabetes mellitus,intraoperative blood loss,neoadjuvant therapy,postoperative ostomy daily discharge≥1 000 mL/d and anastomotic fistula in POAKI group were higher than those in control group,the differences were statistically significant(P<0.05).Preoperative neoadjuvant therapy and high daily ostomy discharge were the risk factors of POAKI in patients with rectal cancer undergoing prophylactic ileostomy(P<0.05).Conclusion:The incidence rate of acute kidney injury after prophylactic ileostomy in rectal cancer patients is 15.89%.Preoperative neoadjuvant therapy for rectal cancer patients will increase the risk of acute kidney injury after prophylactic ileostomy.The high output of postoperative prophylactic terminal ileostomy may indicate the occurrence of POAKI.关键词
直肠癌/预防性回肠造口/术后急性肾损伤/影响因素Key words
Rectal cancer/Prophylactic ileostomy/Postoperative acute kidney injury/Influencing factors
