成人肝移植术中再灌注后低钾血症的预测因子——一项单中心观察研究

Predictors of Hypokalemia after Reperfusion in Adult Liver Transplantation—A Single Center Observational Study

摘要: 目的：通过对肝移植病人围术期数据资料进行统计学处理，寻找影响再灌注后血钾水平的因素，并提出相应的预测公式。方法：我们收集了2017年1月1日至2020年1月1日，在青岛大学附属医院行肝移植手术的273例成年患者的48项临床资料，通过使用SPSS26建立多元线性回归模型，寻找再灌注后20分钟时低钾血症的预测因子。结果：我们发现了开放前血钾、体重、无肝期时间、开放前中心静脉压、每千克体重使用的甲强龙毫克数是开放后20分钟发生低钾血症的预测因子，回归方程是：开放后钾 = 0.804 + 0.68*[开放前钾] + 0.005*[体重] + 0.003*[无肝期时间] − 0.025*[中心静脉压] − 0.05*[甲强龙/体重]。结论：我们找到了成人肝移植再灌注后20分钟低钾血症的五个预测因子。这项研究可以对发生低钾血症的高风险患者进行早期规划和有效干预，有利于患者内环境的稳定和生命安全，这对麻醉管理水平的提高有一定的指导意义。

Abstract: Objective: To find the predictors affecting the serum potassium level after reperfusion by statisti-cally processing the perioperative data of liver transplant patients and then propose the predictive equation. Methods: We collected 48 different clinical data from 273 adult patients who underwent liver transplantation at the Affiliated Hospital of Qingdao University from January 1, 2017 to Janu-ary 1, 2020, and searched for predictors of hypokalemia at 20 minutes after reperfusion by estab-lishing a multiple linear regression model using SPSS 26. Results: We identified pre- reperfusion potassium, body weight, anhepatic period time, central venous pressure, and methylpredniso-lone/weight used as predictors of hypokalemia at 20 minutes after reperfusion, and the predictive equation was: post-reperfusion potassium = 0.804 + 0.68*[pre-reperfusion potassium] + 0.005*[body weight] + 0.003*[anhepatic period time] − 0.025*[central venous pressure] − 0.05*[methylprednisolone/weight]. Conclusion: We found five predictors of hypokalemia at 20 minutes after reperfusion in adult liver transplantation. This study allows early planning and effec-tive intervention in patients at high risk of developing hypokalemia, which contributes to the sta-bility of the patient’s internal environment and life safety, which is a guideline for the improvement of anesthesia management.