中国实用内科杂志2026，Vol.46Issue(4)：322-327,343,7.DOI:10.19538/j.nk2026040109
主动脉夹层术后急性肾损伤需行连续性肾脏替代治疗患者肾功能影响因素分析
Analysis of factors influencing renal function in patients with acute kidney injury requiring continuous renal replacement therapy after aortic dissection surgery
摘要
Abstract
Objective To investigate the risk factors affecting shortterm renal outcome in patients with severe acute kidney injury(AKI)requiring continuous renal replacement therapy(CRRT)after aortic dissection surgery.Methods A retrospective analysis was conducted on 51 patients who developed AKI after aortic dissection surgery and required CRRT at the department of cardiac surgery,Beijing Anzhen Hospital,Capital Medical University,between January 2019 and December 2022.Patients were followed up for 3 months.Baseline clinical data and followup data were collected,and logistic regression analysis was used to identify risk factors affecting renal prognosis.Results A total of 51 patients with complete followup data were finally included,of whom 31(60.8％)achieved complete or partial renal recovery and were weaned from hemodialysis during the 3month clinical followup period.Compared with patients requiring maintenance hemodialysis,those weaned from hemodialysis had a shorter duration of hypotension during the postoperative CRRT period[154(121,198)min vs.163(120,200)min],shorter cardiopulmonary bypass time[198(171,234)min vs.202(192,250)min],and higher left ventricular ejection fraction[60.0(56.0,65.0)vs.58.0(50.8,61.5)].Logistic regression analysis showed that the independent factors for renal recovery in patients with postoperative AKI requiring CRRT was the duration of hypotension during CRRT[OR 0.867,95％CI(0.761-0.987),P=0.031],left ventricular ejection fraction[OR=1.102,95％CI(1.002-1.231),P=0.041].Conclusion The duration of hypotension during postoperative CRRT and postoperative left ventricular ejection fraction are independent factors influencing renal recovery in patients with AKI receiving CRRT after aortic dissection surgery.关键词
急性肾损伤/主动脉夹层/连续性肾脏替代治疗/左室射血分数Key words
acute renal injury/aortic dissection/con-tinuous renal replacement therapy/left ventricular ejection fraction分类
医药卫生引用本文复制引用
杨敏,陈岚,陈文梅,卞维静,王国勤..主动脉夹层术后急性肾损伤需行连续性肾脏替代治疗患者肾功能影响因素分析[J].中国实用内科杂志,2026,46(4):322-327,343,7.基金项目
北京市属医院科研培育计划(PX2022024) （PX2022024）
