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急性下肢深静脉血栓形成的 AngioJet 血栓切除术术后急性肾损伤的危险因素和结果。

Risk factors and outcomes regarding the acute kidney injury after AngioJet thrombectomy for acute lower-extremity deep vein thrombosis.

机构信息

From School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia, China.

Department of Vascular Surgery, Gansu Provincial Hospital, Lanzhou, Gansu, China.

出版信息

Asian J Surg. 2023 Sep;46(9):3505-3511. doi: 10.1016/j.asjsur.2022.10.011. Epub 2022 Nov 1.

Abstract

OBJECTIVE

To investigate the risk factors and outcomes regarding acute kidney injury (AKI) after AngioJet thrombectomy for acute lower-extremity deep vein thrombosis (DVT).

METHODS

Patients were divided into AKI and non-AKI groups according to whether AKI occurred postoperatively. The demographic data, pre-operative and post-operative laboratory data and surgical differences were compared between the two groups. Logistic regression and Wilcoxon signed-rank test were used to identify the AKI risk factors and outcomes, respectively.

RESULTS

Among the 341 patients who met the inclusion criteria, 45 developed AKI (AKI group) and 296 had normal renal function (non-AKI group) post-surgery. There were significant differences between the two groups in the course (t = 10.885, P = 0.000); preoperative history of a major surgery within 3 months (3M-MS) (odds ratio [OR] = 5.492, P = 0.001); duration of aspiration thrombectomy (Z = -8.803, P = 0.000); volumes of aspiration (Z = -8.215, P = 0.000); contrast volume (Z = -3.204, P = 0.001) and pulmonary thrombectomy (OR = 18.200, P = 0.002); and preoperative complications of hypertension (OR = 4.637, P = 0.002), diabetes (OR = 18.088, P = 0.000), or pulmonary embolism (OR = 0.085, P = 0.011). Wilcoxon signed-rank test showed that the renal function of every patient in the AKI group returned to normal 3 months after the surgery.

CONCLUSIONS

The course, preoperative complications of diabetes or hypertension, 3M-MS, contrast volume, duration and volume of aspiration thrombectomy, and pulmonary thrombectomy are risk factors for post-AngioJet-thrombectomy AKI, which is temporary.

摘要

目的

探讨 AngioJet 血栓切除术治疗急性下肢深静脉血栓形成(DVT)后急性肾损伤(AKI)的危险因素和结局。

方法

根据术后是否发生 AKI,将患者分为 AKI 组和非 AKI 组。比较两组患者的人口统计学数据、术前和术后实验室数据及手术差异。采用 logistic 回归和 Wilcoxon 符号秩检验分别识别 AKI 的危险因素和结局。

结果

在符合纳入标准的 341 例患者中,45 例术后发生 AKI(AKI 组),296 例肾功能正常(非 AKI 组)。两组患者在病程(t=10.885,P=0.000)、术前 3 个月内有重大手术史(3M-MS)(优势比[OR]=5.492,P=0.001)、抽吸血栓切除术持续时间(Z=-8.803,P=0.000)、抽吸量(Z=-8.215,P=0.000)、对比剂用量(Z=-3.204,P=0.001)和肺血栓切除术(OR=18.200,P=0.002)方面存在显著差异;术前高血压(OR=4.637,P=0.002)、糖尿病(OR=18.088,P=0.000)或肺栓塞(OR=0.085,P=0.011)并发症。Wilcoxon 符号秩检验显示,AKI 组每位患者的肾功能在术后 3 个月均恢复正常。

结论

病程、术前糖尿病或高血压并发症、3M-MS、对比剂用量、抽吸血栓切除术的持续时间和量以及肺血栓切除术是 AngioJet 血栓切除术后发生 AKI 的危险因素,且为暂时性。

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