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开颅术后急性肾损伤的危险因素、并发症及生物标志物:一项综合性小型综述

Risk factors, complications and biomarkers associated with acute kidney injury after craniotomy: a comprehensive mini-review.

作者信息

Dalil Davood, Kianparsa Joben, Isakhani Mahdi, Ostadzadeh Mahdieh, Ravand Fatemeh

机构信息

Department of Internal Medicine, Faculty of Medicine Shahed University Tehran Iran.

Student Research Committee, Faculty of Medicine Shahed University Tehran Iran.

出版信息

Acute Med Surg. 2024 Nov 11;11(1):e70020. doi: 10.1002/ams2.70020. eCollection 2024 Jan-Dec.

Abstract

Acute kidney injury (AKI) is a devastating medical condition that occurs mostly in hospitalized patients after a serious illness or major surgery and imposes a great health and financial burden on patients. Craniotomy is one of the major surgeries in which people who undergo this operation experience critical clinical conditions. Systemic inflammation, hemodynamic variation, and pharmacological agents administered during and after craniotomy can lead to the development of AKI and a poor prognosis. Moreover, AKI itself could cause other significant complications and increase the mortality rate in patients who undergo craniotomy. Determining the pre-, peri-, and postoperative risk factors associated with AKI after craniotomy is important for its prevention. Efficient care of patients after craniotomy and effective treatment approaches should be implemented to maintain normal metabolism, enhance nerve function recovery, and control inflammation. Novel biomarkers have been recognized as reliable indicators for the diagnosis and prognosis of AKI after brain surgery. This study aimed to summarize the most relevant literature regarding the risk factors, postoperative complications, and mortality associated with AKI after craniotomy. Moreover, we reviewed the approaches to postoperative care, followed by an overview of the significant diagnostic or prognostic biomarkers of AKI following craniotomy to provide a basis for preventing and decreasing AKI.

摘要

急性肾损伤(AKI)是一种严重的医学病症,主要发生在重病或大手术后的住院患者中,给患者带来巨大的健康和经济负担。开颅手术是主要手术之一,接受该手术的患者会经历危急的临床状况。开颅手术期间及术后的全身炎症、血流动力学变化以及使用的药物都可能导致AKI的发生和预后不良。此外,AKI本身可能引发其他严重并发症,并增加开颅手术患者的死亡率。确定开颅术后与AKI相关的术前、术中和术后危险因素对其预防至关重要。应实施开颅术后患者的有效护理和有效的治疗方法,以维持正常代谢、促进神经功能恢复并控制炎症。新型生物标志物已被公认为脑手术后AKI诊断和预后的可靠指标。本研究旨在总结与开颅术后AKI相关的危险因素、术后并发症和死亡率的最相关文献。此外,我们回顾了术后护理方法,随后概述了开颅术后AKI的重要诊断或预后生物标志物,为预防和减少AKI提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d00a/11551589/9263838f288d/AMS2-11-e70020-g002.jpg

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