术中冷沉淀输血对原位肝移植后急性肾功能衰竭的影响思维导图.pptVIP

主讲：周权 常德市第一人民医院 SCI文章解析实例1 术中冷沉淀输血对原位肝移植后急性肾功能衰竭的影响 The effects of intraoperative cryoprecipitate transfusion on acute renal failure following orthotropic liver transplantation 术中冷沉淀输血对原位肝移植后急性肾功能衰竭的影响 来自： Hepatology International （国际肝病）杂志，IF=1.125 案例分析 冷沉淀物 Purpose The definition of risk factors associated with acute renal failure (ARF) following orthotropic liver transplantation (OLT) is still controversial. Cryoprecipitate, which can supply fibrinogen and other coagulation factors, is widely used in OLT. However, the effects of intraoperative cryoprecipitate transfusion on ARF following OLT remain unclear. 研究目的 原位肝移植（OLT）术后发生急性肾功能衰竭（ARF）的危险因素定义仍有争议。在临床上，冷冻沉淀输血因可以提供纤维蛋白原和其他凝血因子而被广泛应用于OLT，但OLT术后冷冻沉淀输血对ARF的影响尚不清楚。 ABSTRACT 原位肝移植（OLT）术后发生急性肾功能衰竭（ARF）的危险因素定义仍有争议。在临床上，冷冻沉淀输血因可以提供纤维蛋白原和其他凝血因子而被广泛应用于OLT，但OLT术后冷冻沉淀输血对ARF的影响尚不清楚。 Methods In a series of 389 adult patients who received grafts from deceased donors and underwent their first OLT, the clinical correlation between intraoperative cryoprecipitate transfusion and ARF following OLT was retrospectively studied after adjusting for potential confounders. The distribution of ARF and the causes of death within the first year after OLT were also compared separately in patients with and without cryoprecipitate transfusion. 研究方法 本文纳入了389名第一次接受肝移植的手术者，对术中冷沉淀输血与OLT术后ARF的临床相关性进行了回顾性研究。对有无冷沉淀输血患者一年ARF分布和死亡原因分布进行比较。 Results The incidence of ARF in patients with cryoprecipitate transfusion was significantly higher than in patients without cryoprecipitate transfusion (15.9 vs. 7.8?%,?p?=?0.012). A nonlinear relationship between intraoperative cryoprecipitate transfusion and ARF following OLT was observed. The risk of ARF increased with the cryoprecipitate transfusion level up to the turning point (16?U) (adjusted OR 1.1, 95?% CI 1.1–1.2;?p??0.001). When the cryoprecipitate level exceeded 16?U, the level of cryoprecipitate transfusion was not associated with the risk of ARF (OR 0.95, 95?% CI 0.85–1.1;?p?=?0.319). Dea