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초록· 키워드

상세정보 수정요청해당 페이지 내 제목·저자·목차·페이지
정보가 잘못된 경우 알려주세요!
수술 전후의 저알부민혈증은 다양한 코호트 연구에서 환자의 사망률과
이환율과 관련된 예후를 예측할 수 있는 것으로 보고된 바 있다. 파열된 복부
대동맥류(rAAA) 개복술을 받는 환자는 출혈 및 기저 질환으로 인한
저알부민혈증의 위험이 높다. 따라서 본 연구에서는 복부대동맥류 파열로
인조 혈관 치환술을 시행받는 환자에서 수술 후 저알부민혈증이 급성 신
손상(AKI)의 발생을 예측할 수 있는지 알아보고자 하였다.
강남 세브란스 병원에서 2008년 1월부터 2022년 5월까지 복부 대동맥류 인조
혈관 치환술을 시행 받은 환자 143명을 대상으로 후향적 연구를 진행하였으며
대상자들은 중앙값인 수술 직후 혈청 알부민 수치 2.4g/dL를 기준으로 두
군으로 나누어 수술 후 급성 신손상의 유무 및 환자의 예후를 비교하였다.
또한 급성 신 손상의 발생 여부에 따라 두 군으로 나누어 수술 후 혈청
알부민 값에 유의한 차이가 있는지 비교하였다.
수술 후 급성신손상의 발생은 저알부민혈증 군에서 유의미하게 높았으며
(27.7% vs. 53.8% p=0.002) 저알부민혈증 군에서 기관삽관 재시도, 신장대체요법,
병원내 사망, 수술 후 30일 이내 사망한 비율이 모두 높게 확인되었다.
급성신손상이 발생한 군의 혈청 알부민 농도 역시 발생하지 않은 군에 비하여
유의미하게 낮게 나타났다. (2.59 ± 0.62 vs. 2.11 ± 0.62, p < 0.001) 다변수
로지스틱 회귀분석에서도 수술 후 저알부민혈증이 급성신손상의 독립적인
예측변수로 확인되었다. (odds ratio: 0.310, 95% confidence interval: 0.165–0.583,
p<0.001)
수술 후 저 알부민혈증은 복부대동맥류 파열로 수술을 받은 환자들에서 급성
신손상을 위한 독립적인 예측 변수로 생각할 수 있으며, 이는 수술 후 혈청
알부민 수치의 파악 및 수술 후 혈청 알부민 수치의 상승을 위한 수술 중
알부민 보충이 환자의 급성신손상을 막고 나쁜 예후를 줄이는 데에 도움이 될
수 있음을 시사한다.
#albumin #hypoalbuminemia #aortic repair #ruptured abdominal aortic aneurysm #acute kidney injury

목차

  1. ABSTRACT················································································iii
    I. INTRODUCTION ······································································· 1
    II. MATERIALS AND METHODS····················································· 2
    1. Study population······································································ 2
    2. Perioperative management ·························································· 3
    3. Study endpoint ········································································ 3
    4. Other assessments ···································································· 4
    5. Statistical analyses ···································································· 4
    III. RESULTS ············································································· 4
    1. Baseline characteristics and laboratory data, stratified according to the occurrence
    of acute kidney injury ······································································ 6
    2. Baseline characteristics and laboratory data, stratified according to postoperative
    albumin level ············································································· 9
    3. Operation related data ·······························································10
    4. Postoperative morbidity and mortality··········································11
    5. Logistic regression analysis for the predictors of acute kidney injury after rAAA
    open repair ·················································································13
    IV. DISCUSSION ·······································································14
    V. CONCLUSION ·······································································17
    REFERENCES ···········································································18
    ABSTRACT(IN KOREAN) ····························································23

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