关键词: 维持性血液透析, 全麻, 术后并发症

Abstract: Objective To analyze the complications after general anesthesia surgery (excluding renal transplantation) and the related factors in maintenance hemodialysis (MHD) patients. Methods We recruited the clinical data of 54 end-stage renal disease on MHD patients who underwent general anesthesia surgery for other diseases and were treated in our hospital in the period between Jan. 2009 and Dec. 2013. Their postoperative complications and the related factors were retrospectively analyzed. We also recruited 60 patients with normal renal function and subjected general anesthesia surgery during the same period as the controls.Results Postoperative complication rate was significantly higher in MHD patients than in controls (48.1% vs. 10.0%, P＜0.01). The most common complication was hypertension (20.4%), followed by pulmonary infection (14.8%) and heart events (13.0%) with longer hospitalization period (22.37±13.57 vs. 10.82±6.09 days, P＜0.01). However, the postoperative mortality was statistically indifferent as compared with that of the controls (7.4% vs. 1.7%, P=0.188). Diabetic nephropathy as the primary disease, preoperative hypoalbuminemia, and intraoperative hemorrhage >400 ml caused the increase of postoperative complications. Multivariate logistic regression suggested that diabetic nephropathy was the independent risk factor to predict whether postoperative complications occurred (OR=17.914; 95% CI: 1.164～275.802; P=0.039). Conclusions MHD patients subjected to general anesthesia surgery usually have longer hospitalization period and higher prevalence of postoperative complications, especially those with preoperative hypoalbuminemia, intraoperative
bleeding, and diabetic nephropathy. Diabetic nephropathy is the independent risk factor for postoperative complications in MHD patients

Key words: maintenance hemodialysis, general anesthesia, postoperative complication