摘要
目的探讨肾部分切除术患者术后出入量观测的最佳时间窗及对急性肾损伤的预测价值。方法 收集2014年12月-2015年12月在北京协和医院行肾部分切除术后规律复诊的134 例肾癌患者资料,记录术后每小时的入量、尿量,采用受试者工作特征(ROC)曲线来探讨肾部分切除术患者出入量观测的最佳时间窗及对急性肾损伤的预测价值。结果 134例患者中有19.4%患者发生急性肾损伤,急性肾功能损伤组术后10、14、16、18 h各时间窗出入量差值均大于非急性肾功能损伤组( P<0.05)。多元回归分析显示,术后10 h时间窗出入量和热缺血时间是术后肾损伤的独立危险因素( P<0.05)。术后10 h时间窗出入量对于急性肾损伤具有一定的预测价值,其ROC曲线下面积为0.747(95%CI:0.592~0.903, P<0.05)。结论术后10 h可成为肾部分切除术患者术后急性肾损伤出入量观测的最佳时间窗。
Objective To explore the best time window of intake and output volume observation after partial nephrectomy and its predictive value for acute renal injury.Methods The information of totally 134 renal cancer patients with regular subsequent visits after partial nephrectomy in Peking Union Medical College Hospital from December 2014 to December 2015 were collected.The intake and urine volume per hour was recorded.The receiver operating characteristic (ROC)curve was used to explore the best time wind of intake and output volume observation and its predictive value for acute renal injury in patients with partial nephrectomy. Results Acute renal injury was found in 19.4% of the 134 patients.The differences between intake and output volumes 10,14,16 and 18h postoperatively in the acute renal injury group were bigger than those in the non acute renal injury group (P <0.05).According to the multiple regression analysis,the intake and output volume 10h postoperatively and the time of warm ischemia were the independent risk factors to postoperative renal injury (P <0.05).The intake and output volume 10h postoperatively had predictive power to acute renal injury, whose area under the ROC was 0.747(95%CI:0.592-0.903,P<0.05).Conclusions The intake and output volume 10h postoperatively may be the best time window for observing the intake and output volume in patients with acute renal injury after partial nephrectomy.
作者
王晓晶
郑丹萍
杨雨佳
申彦雅
秦瑛
Wang Xiaojing;Zheng Danping;Yang Yujia;Shen Yanya;Qin Ying(International Medical Services Department,Peking Union Medical College Hospital,Beijing 100730,China)
出处
《中华现代护理杂志》
2018年第31期3754-3759,共6页
Chinese Journal of Modern Nursing
基金
北京协和医院2014年度护理科研基金(XHHLKY201414).
关键词
肾切除术
急性肾损伤
时间窗
出入量
受试者工作特征曲线
Nephrectomy
Acute renal injury
Time window
Intake and output volume
The curve of the receiver operating characteristic
