关键词:

急性主动脉夹层, 连续肾脏替代疗法, 危险因素

Abstract:

Objective The aim of this study was to analyzed the CRRT factors of acute Stanford type A aortic dissection surgery retrospectively and identify the risk factors for CRRT after acute Stanford type A aortic dissection surgery. Methods 115 patients（93 males and 22 females，at a mean age of（53.16 ± 11.43）years with acute Stanford type A aortic dissection at the cardiovascular surgery department of our hospital from September 2020 to December 2021）were collected and retrospectively analyzed. 23 patients were acute kidney injury after re⁃ ceive acute Stanford type A aortic dissection surgery were assigned into the CRRT group，and the remaining pa⁃ tients（n = 92）were included in the non⁃CRRT group. The perioperative data were reviewed and the risk factors were identified by univariate analysis，which further confirmed by logistic regression. Results There were 19 pa⁃ tients dead during perioperative period in our study. There were 9 deaths in the CRRT group and 10 deaths in the non⁃CRRT group. The mortality of the two groups was statistically significant（χ2 = 10.655，P = 0.001）. Univariate analysis identified Preoperative creatinine，block time，extracorporeal circulation time，operation time，intraopera⁃ tive red blood cell volume，intraoperative plasma volume were risk factors for CRRT after acute Stanford type A aor⁃ tic dissection surgery. Logistic regression analysis further identified preoperative creatinine （OR = 1.875，P = 0.014），blocking time（OR = 1.874，P = 0.008），time of operation（OR = 1.014，P = 0.012）and intraoperative erythrocyte transfusion（OR = 2.183，P = 0.017）were independent risk factors for CRRT after acute Stanford type A aortic dissection surgery. The receiver operating characteristic（ROC）curve analysis showed that preoperative creatinine was the most effective in predicting postoperative CRRT of acute Stanford type A aortic dissection.Conclusion It was confirmed that preoperative creatinine，block time，CPB time and intraoperative red blood cell volume were independent risk factors for CRRT after acute Stanford Type A aortic dissection. Effective perioperative assessment and management of patients can reduce the risk of CRRT after acute Stanford type A aortic dissection.

Key words:

acute type A aortic dissection, CRRT, risk factors ,