Song Yang, Liang Si, Wei Ming, Chen Hong, Wang Liping, Wang Yu
Department of Anesthesiology, Harbin Medical University Cancer Hospital, No. 150 Haping Rd., Nangang District, Harbin, 150081, China.
Department of Anesthesiology, Affiliated Hospital of He Bei University, Baoding, 071000, China.
BMC Anesthesiol. 2025 Aug 27;25(1):429. doi: 10.1186/s12871-025-03330-5.
Acute kidney injury (AKI) is a common complication of major abdominal surgery that is associated with adverse patient outcomes including death. The objective of this study was to investigate the incidence of postoperative AKI after gastric cancer surgery, comparing patients who received propofol-based TIVA with those who received sevoflurane-based INHA.
We analyzed the medical records of all patients aged 19 years or older who underwent radical surgery for primary gastric cancer at the Harbin Medical University Cancer Hospital between January 2010 and September 2018. After propensity score matching, the incidence of AKI in the first 3 postoperative days was compared between patients who received propofol and those who received sevoflurane.
3533 patients were included in the study. After propensity score matching, 1206 patients were assigned to each group. The logistic regression analysis showed that the incidence of AKI was not different in the two groups before (OR 1.05, 95% CI 0.80 to 1.38, P = 0.731) and after propensity score matching (OR 1.02, 95% CI 0.71 to 1.47, P = 0.926). Before propensity score matching, acute kidney injury occurred in 146 sevoflurane and 85 propofol patients. The overall incidence was 6.4% in the sevoflurane group and 6.7% in the propofol group. After propensity score matching, acute kidney injury occurred in 60 sevoflurane and 61 propofol patients. The overall incidence was 5.0% in the sevoflurane group and 5.1% in the propofol group.
In this retrospective study, no significant difference was found in the incidence of postoperative AKI after gastrectomy between patients who received propofol-based TIVA and those who received sevoflurane-based INHA in this retrospective study.
急性肾损伤（AKI）是腹部大手术常见的并发症，与包括死亡在内的不良患者预后相关。本研究的目的是调查胃癌手术后术后AKI的发生率，比较接受丙泊酚全凭静脉麻醉（TIVA）的患者和接受七氟醚吸入麻醉（INHA）的患者。
我们分析了2010年1月至2018年9月在哈尔滨医科大学附属肿瘤医院接受原发性胃癌根治手术的所有19岁及以上患者的病历。在倾向评分匹配后，比较接受丙泊酚和接受七氟醚的患者术后前3天AKI的发生率。
3533例患者纳入研究。倾向评分匹配后，每组分配1206例患者。逻辑回归分析显示，在倾向评分匹配前（比值比1.05，95%可信区间0.80至1.38，P = 0.731）和匹配后（比值比1.02，95%可信区间0.71至1.47，P = 0.926），两组AKI的发生率无差异。在倾向评分匹配前，146例七氟醚患者和85例丙泊酚患者发生急性肾损伤。七氟醚组的总发生率为6.4%，丙泊酚组为6.7%。倾向评分匹配后，60例七氟醚患者和61例丙泊酚患者发生急性肾损伤。七氟醚组的总发生率为5.0%，丙泊酚组为5.1%。
在这项回顾性研究中，接受丙泊酚TIVA的患者和接受七氟醚INHA的患者在胃切除术后术后AKI的发生率上没有发现显著差异。
