摘要
目的探讨RIFLE肾功能分级系统与住院死亡的相关关系，并探讨其对病人转归的预测意义。方法收集2004年10月至2006年11月40例心脏手术后应用体外膜肺氧合（ECMO）进行支持治疗的成年病人资料，包括术后呼吸机辅助时间、监护室停留时间及转归等。结果ECMO辅助平均（56．84±44．1）h。32例成功脱离ECMO，脱机率为80％，22例生存出院，总病死率45％。RIFLE分级系统ROC曲线下面积为0．904（95％可信区间0．798～1．010，P〈0．01）与病死率之间有很好的相关性。结论RIFLE分级系统能够可靠预测ECMO辅助治疗病人的预后及死亡，应用简便、快捷。
Objective Summarize experience on extracorporeal membrane oxygenation （ECMO） for cardiac surgery, and characterize the association between mortality and RIFLE （risk of renal failure, injury to the kidney, failure of kidney function, loss of kidney function and end-stage renal disease） classifiction. Methods From October 2004 to November 2006, 40 patients undergoing ECMO after cardiac surgery, the duration of ventilation support, ICU stay and outcomes were recorded. Results Mean duration of ECMO was （56.8 ±44.1 ）hours. Thirty-two patients（80% ） were successfully weaned from ECMO, twenty-two patients（55% ） were discharged from hospital. The overall mortality rate was 45%. A significant increase （ X^2 for trend, P 〈 0.01）in mortality was observed based on RIFLE classification. By applying the area under the receiver operating characteristic curve （AUROC）, the RIFLE classification is a tool of good discriminative power [AUROC 0.904, （95%CI 0.798-1.010）, P〈0.01]. Conclusion The RIFLE classification is a simple and valuable method with good prognostic capability to evaluate acute renal failure after cardiac surgery with ECMO.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2008年第1期26-29,共4页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
心脏外科手术
体外膜肺氧合作用
肾功能衰竭
急性
RIFLE分级
Cardiac surgical procedures Extracorporeal membrane oxygenation Kidney failure ,acute RIFLE classification
