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目的分析术后早期急性肾功能衰竭(ARF)发生的相关危险因素。方法回顾性研究我中心127例肝移植病例,分为ARF组(n=26)和非ARF组(n=101),对比分析两组病人术前的血清总胆红素水平、凝血酶原活动度、终末期肝病模型评分和血清肌酐水平,观察是否存在肾脏结构性病变、休克、消化道出血,是否大量放腹水、行血浆置换治疗,是否需要肾脏替代治疗,术中是否应用静脉静脉转流,术中输血量情况及使用免疫抑制剂的种类等相关因素,通过Logistic回归分析确定术后早期发生ARF的相关危险因素。结果多因素分析表明,术前高血清肌酐水平和低凝血酶原活动度水平是肝移植术后发生ARF的危险因素(P<0.05)。结论肝移植术后ARF发病率较高,术前高血清肌酐和低凝血酶原活动度水平是肝移植术后早期ARF的独立危险因素。
Objective To analyze the related risk factors of acute postoperative acute renal failure (ARF). Methods A total of 127 cases of liver transplantation in our center were retrospectively studied. The patients were divided into ARF group (n = 26) and non-ARF group (n = 101). The levels of serum total bilirubin, prothrombin Degree, end-stage liver disease model score and serum creatinine levels were observed to see if there were renal structural lesions, shock, gastrointestinal bleeding, whether a large number of ascites, plasma replacement therapy, the need for renal replacement therapy, intraoperative intravenous venous bypass , Intraoperative blood transfusion and the types of immunosuppressants used and other relevant factors, Logistic regression analysis to determine the risk factors associated with early postoperative ARF. Results Multivariate analysis showed that preoperative high serum creatinine and low prothrombin activity were risk factors of ARF after liver transplantation (P <0.05). Conclusion The incidence of ARF after liver transplantation is relatively high. Preoperative serum creatinine and low prothrombin activity levels are independent risk factors for early ARF after liver transplantation.