脑肿瘤患者术中低血压与术后急性肾损伤的相关性

Association between intraoperative hypotension and postoperative acute kidney injury in patients undergoing brain tumor resection

中文关键词: 急性肾损伤  脑肿瘤  术中低血压

英文关键词: Acute kidney injury  Brain tumor  Intraoperative hypotension

中文摘要:

      
目的：探讨脑肿瘤切除术中低血压与术后急性肾损伤（AKI）的相关性。
方法：筛选择期行脑肿瘤切除术的患者428例，男276例，女152例，年龄≥18岁，BMI 15～36 kg/m²，ASA Ⅱ或Ⅲ级。根据术后是否发生AKI将患者分为两组：AKI组和非AKI组。本研究定义了3个低血压阈值，分别为术中MAP<65 mmHg、60 mmHg和55 mmHg，采用多因素Logistic回归分析3个不同阈值下术中低血压与术后AKI的相关性。
结果：共有107例发生术后AKI。多因素回归分析结果显示，术中MAP<65 mmHg （OR=1.11，95%CI 1.03～1.20，P=0.010）和术中MAP<60 mmHg（OR=1.12，95%CI 1.02～1.23，P=0.017）与术后AKI的发生相关。
结论：术中MAP<65 mmHg和60 mmHg与脑肿瘤切除术后AKI的发生相关。

英文摘要:

      
Objective: To investigate the association between intraoperative hypotension and postoperative acute kidney injury (AKI) in patients undergoing brain tumor resections.
Methods: A total of 428 patients undergoing elective craniotomy for tumor resection were selected, 276 males and 152 females, aged ≥ 18 years, BMI 15-36 kg/m², ASA physical status Ⅱ or Ⅲ. Based on postoperative occurrence of AKI, the patients were divided into two groups: the AKI group and the control group. This study defined three thresholds for hypotension, including MAP during surgery below 65 mmHg, 60 mmHg, and 55 mmHg. Multivariate logistic regression was used to analyze the correlation between intraoperative hypotension and postoperative AKI under three thresholds.
Results: A total of 107 patients had postoperative AKI. The results of multivariable regression analysis indicated that intraoperative MAP < 65 mmHg (OR = 1.11, 95% CI 1.03-1.20, P = 0.010) and intraoperative MAP < 60 mmHg (OR = 1.12, 95% CI 1.02-1.23, P = 0.017) were associated with postoperative AKI.
Conclusion: Intraoperative MAP <65 mmHg or 60 mmHg is associated with postoperative AKI in patients undergoing brain tumor resection.