摘要
目的总结颅内肿瘤围手术期发生急性肾损伤患者的临床资料;结合文献复习探讨行颅内肿瘤切除术患者发生围手术期急性肾损伤的可能危险因素.方法回顾性分析2016年1月至2018年12月首都医科大学附属北京天坛医院神经外科收治的发生围手术期重度急性肾损伤的4例颅内肿瘤患者[占同期收治的颅内肿瘤手术患者的0.03%(4/13333)]的临床资料.4例患者均行肿瘤切除术.结果术后病理学结果提示,脑膜瘤2例,垂体腺瘤1例,颅咽管瘤1例.术前2例患者术前血糖高于正常值(其中1例有糖尿病史),2例发生术中低血压,2例手术时间>3h,3例围手术期使用了肾毒性药物.结论对于颅内肿瘤切除术患者,术前若合并糖尿病或存在高血糖、应用肾毒性药物、手术时间>3h或术中发生低血压,可能更易发生围手术期急性肾损伤.
Objective To summarize the clinical data of patients with acute kidney injury(AKI)during perioperative period of intracranial tumor resection and review the literatures to explore the possible risk factors for perioperative AKI.Methods We retrospectively analyzed the clinical data of 4 patients with intracranial tumor who developed severe perioperative AKI(accounting for about 0.03%of the patients with intracranial tumor undergoing operation during the same period)at Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University from January 2016 to December 2018.All 4 patients underwent tumor resection.Results Postoperative pathological examination indicated 2 cases of meningioma,1 case of pituitary adenoma and 1 case of craniopharyngioma.Two patients had hyperglycemia prior to surgery(one patient had a history of diabetes),two patients had intraoperative hypotension,two patients had an operation time>3 h,and three patients were administered nephrotoxic drugs perioperatively.Conclusion For patients undergoing intracranial tumor resection,perioperative AKI may be more likely to occur if there are factors including diabetes,hyperglycemia,nephrotoxic drugs,operation time>3 h,and intraoperative hypotension.
作者
赵岩
李嘉欣
李姝
吴胜田
曾敏
彭宇明
Zhao Yan;Li Jiaxin;Li Shu;Wu Shengtian;Zeng Min;Peng Yuming(Department of Anesthesiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)
出处
《中华神经外科杂志》
CSCD
北大核心
2020年第5期487-490,共4页
Chinese Journal of Neurosurgery
基金
国家重点研发项目(2018YFC2001901)
首都卫生发展科研专项项目(2018-2-2044)
北京市属医院科研培育计划项目(PX2018023)
首都临床诊疗技术研究及示范应用(Z191100006619068)。
关键词
脑肿瘤
神经外科手术
急性肾损伤
围手术期并发症
危险因素
Brain neoplasms
Neurosurgical procedures
Acute kidney injury
Perioperative complications
Risk factors
