全凭静脉麻醉下神经外科手术急性肾损伤高危因素回顾性分析

摘要

目的:回顾性分析全凭静脉麻醉下神经外科手术急性肾损伤发生的高危因素.方法:选择200例神经外科手术患者的临床资料,根据是否发生急性肾损伤分为并发急性肾损伤组(阳性组)17例和未并发急性肾损伤组(对照组)183例.研究患者发生急性肾损伤的危险因素.结果:患者术后尿素、术后肌酐、术前尿酸、术后尿酸、术中动脉血乳酸值、入室GCS评分、术前肾小球滤过率较对照组差异有统计学意义(P＜0.05).Logistic回归分析显示,术中动脉血乳酸值、术前肾小球滤过率与神经外科手术并发急性肾损伤独立相关.结论:术中动脉血乳酸值及术前肾小球滤过率是导致神经外科手术患者在全凭静脉麻醉下并发急性肾损伤的独立危险因素,为神经外科手术围术期肾损伤的预防和治疗提供参考依据.%Objective:To explore the risk factors for acute kidney injury (AKI) in neurosurgical patients under total intravenous anesthesia.Methods:Clinical data of 200 neurosurgery patients were retrospectively observed.Patients were divided into experimental group (acute renal injury group,17 cases) and control group (183 cases).The risk of acute kidney injury in patients was analyzed.Results:The postoperative urea,creatinine,uric acid,postoperative urea acid,preoperative arterial blood lactic acid,preoperative GCS score,preoperative glomerular filtration rate in the experimental group showed statistically significant differences (P＜0.05) in comparison with control group.Logistic regression analysis showed that intraoperative blood lactic acid value and preoperative glomerular filtration rate were independently associated with AKI in neurosurgical patients.Conclusion:Arterial blood lactic acid value and preoperative glomerular filtration rate are independent risk factors of AKI in neurosurgical patients.The results provide support for the prevention and treatment of perioperative renal injury in neurosurgical patients.