| 曾颖 何斌 高峻青.高龄患者股骨颈骨折术后急性肾损伤的危险因素分析[J].实用中西医结合临床,2015,15(5):10-12 |
| 高龄患者股骨颈骨折术后急性肾损伤的危险因素分析 |
| Risk Factors for Acute Kidney Injury after Artificial Hip Replacement in the Elderly Patients with Femoral Neck Fracture |
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| DOI： |
| 中文关键词: 急性肾损伤 髋关节置换术 危险因素 |
| 英文关键词: Acute kidney injury Hip fracture surgery Risk factor |
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| 中文摘要: |
| 目的：探讨高龄患者股骨颈骨折行人工髋关节置换术后急性肾损伤（AKI）的危险因素。方法：连续收集于2010年4月~2014年7月就诊于佛山市中医院的163例股骨颈骨折患者（＞65岁），根据术后48~72 h内血清肌酐绝对值升高＞0.3 mg/dl定义为AKI，前瞻性观察发生AKI和未发生AKI两组患者的基线资料及院内临床事件；采用多因素logistic回归分析AKI的危险因素。结果：163例患者中25例（15.3%）患者发生AKI，3例（1.8%）患者最终需要进行血液透析治疗。AKI患者平均（4.84±1.34） d内血清肌酐恢复到基线水平，出院后随访3个月内未发现患者需要肾脏替代治疗包括血液透析。与未发生AKI患者相比，AKI患者的平均住院天数多3 d。多因素回归分析显示，只有较低的估算肾小球滤过率水平（比值比0.95；95%可信区间，0.92~0.96，P＜0.001）是AKI的独立危险因素。结论：AKI是高龄患者股骨颈骨折行人工髋关节置换术后的常见并发症，发生率较高，且与更长的住院时间相关。同时，较低的基础肾功能是预测AKI发生的独立危险因素。 |
| 英文摘要: |
| Objective: To evaluate the risk factors of acute kidney injury (AKI) in the elderly patients with femoral neck fracture after artificial hip replacement. Methods: 163 patients (＞65 years) with femoral neck fracture were enrolled between 2010 and 2014 in our hospital. The risk factors of AKI were evaluated by multivariate logistic regression analysis. AKI was defined as ≥0.3 mg/dl increase from baseline serum creatinine (SCr) within 48~72 hours after artificial hip replacement. Results: Among 163 patients, AKI occurred in 25 (15.3%) patients. 3 (1.8%) patients required renal replacement therapy (RRT). Baseline SCr levels were restored within (4.84±1.34) days on average. No patient required RRT after discharge. The mean hospital stay was 3 days longer for the patients with AKI. After multivariable adjustment, only lower estimated glomerular filtration rate levels (odds ratio 0.95, 95% confidence interval 0.92~0.96, P＜0.001) emerged as an independent predictor for AKI. Conclusion: The AKI represents a frequent complication after artificial hip replacement and associates with longer hospital stay, higher treatment costs and more morbidity. Moreover, baseline renal function is an independent predictor of AKI. |
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