国际麻醉学与复苏杂志   2017, Issue (3): 0-0
    
术中输注两种类型胶体液对青少年脊柱侧凸患者肾功能影响的回顾性研究
贾锐, 李娜, 马正良, 顾小萍1()
1.南京大学医学院附属鼓楼医院麻醉科
Influence of Two Types of Intraoperative Colloids Infusion on the Renal Function of Adolescent Patients with Scoliosis:A Retrospective Study
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摘要:

目的 回顾性比较脊柱后路矫形术中输注6%羟乙基淀粉(130/0.4)和4%琥珀酰明胶对于青少年脊柱侧凸患者肾功能等预后的影响。 方法 收集2011年11月~2015年10月于南京鼓楼医院行脊柱后路矫形术的青少年脊柱侧凸患者病案资料共1019例。按照术中输注胶体的类型,将患者分为羟乙基淀粉组(H组)和琥珀酰明胶组(G组),记录并比较两组患者性别、年龄、ASA分级、身体质量指数(Body Mass Index, BMI)、手术时长、术中出血量、输液量、术后引流量、术后住院天数、围术期血制品输注及实验室检查情况等围术期资料。 结果 H组比G组的急性肾功能损伤(Acute Kidney Injury, AKI)发生率高:0.82% (7/849) 和 0.00%(0/170),但差异不具有统计学意义(P>0.05);两组患者的术后住院时间、血制品输注情况、术后引流量的差异无统计学意义。 结论 脊柱后路矫形术中输注羟乙基淀粉和琥珀酰明胶对青少年脊柱侧凸患者的肾功能等预后影响无差异。

关键词: 羟乙基淀粉;琥珀酰明胶;脊柱侧凸;急性肾功能损伤
Abstract:

Objective To compare the renal function and prognosis between 6% hydroxyethyl starch(130/0.4) and 4% succinylated gelatin during posterior spinal orthopaedic surgery for patients of adolescent scoliosis. Methods 1019 medical cases of adolescent patients with scoliosis who had underwent posterior spinal orthopaedic surgery in Nanjing Drum Tower Hospital from November 2011 to October 2015 were retrospectively reviewed. According to the types of colloids, patients were divided into two groups : hydroxyethyl starch(group H) and succinylated gelatin(group G). Patients’ demographic and perioperative information including sex, age, ASA grade, Body Mass Index(BMI), duration of operation, the volume of intraoperative fluid therapy, blood loss, postoperative drainage, the length of hospital stay(LOS) after surgery, perioperative blood transfusion and laboratory tests were collected and compared between the two groups. Results The incidence of acute kidney injury(AKI) in group H was higher than group G:0.08% (7/849) vs. 0.00%(0/170), but the difference was not statistically significant(P<0.05); With regards to LOS after surgery , blood transfusion or postoperative drainage, there were no significant differences between the two groups. Conclusions There were no significant differences in incidence of AKI and prognosis between hydroxyethyl starch and succinylated gelatin during posterior spinal orthopaedic surgery for adolescent scoliosis.

Key words: Hydroxyethyl starch; Succinylated gelatin; Scoliosis; Acute Kidney Injury