O'Donnell D, Clarke G, Hurst P
Department of Nephrology, Royal Perth Hospital, Western Australia.
Aust N Z J Surg. 1989 May;59(5):405-8. doi: 10.1111/j.1445-2197.1989.tb01595.x.
Between January 1974 and April 1986, 440 patients underwent elective or emergency repair of abdominal aortic aneurysms at this hospital. Acute renal failure requiring dialysis following repair occurred in 32 patients (7.3%) and form the basis of this report. All were male patients of mean age 69 years; 21 (66%) gave a history of other major medical problems and 19 (59%) used medication for these medical conditions. Twelve patients (37.5%) survived to leave hospital. No differences were observed between survivors and non-survivors with regard to age, previous medical condition, drug therapy, or creatinine value on admission. Mode of presentation, duration of surgery, frequency of hypotension and number of blood transfusions were similar in both groups. Total hospital stay and duration of intensive care were distributed equally between the two groups. Those who survived seemed to require less inotropic support and a shorter duration of ventilation than the non-survivors; the continued need for these support and persistent leucocytosis greater than 15,000/mm3 were associated with little chance of survival.
1974年1月至1986年4月期间,本院有440例患者接受了腹主动脉瘤择期或急诊修复手术。术后发生需要透析的急性肾衰竭的患者有32例(7.3%),本报告即以此为基础。所有患者均为男性,平均年龄69岁;21例(66%)有其他重大疾病史,19例(59%)因这些疾病正在用药。12例患者(37.5%)存活出院。在年龄、既往疾病状况、药物治疗或入院时的肌酐值方面,存活者与非存活者之间未观察到差异。两组患者的表现方式、手术时长、低血压发生频率及输血次数相似。两组的总住院时间和重症监护时长分布相当。存活者似乎比非存活者需要更少的强心支持和更短的通气时间;持续需要这些支持以及持续存在白细胞计数高于15,000/mm³与存活几率低相关。