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目的:探讨急性Stanford A型主动脉夹层（简称A型夹层）手术后发生急性肾损伤行连续性肾脏替代治疗（CRRT）患者出院后90 d内死亡的预后因素。方法:回顾性分析2016年7月至2019年2月于首都医科大学附属北京安贞医院心脏外科因急性A型夹层术后发生急性肾损伤应用CRRT的126例患者的临床资料。男性83例，女性43例，年龄（52.9±11.2）岁（范围：25~70岁）。记录患者的人口学特征、疾病相关信息、围手术期资料、CRRT期间检验指标、并发症及患者出院后90 d内生存信息。通过Kaplan-Meier生存分析、单因素和多元Cox比例风险模型确定患者出院后90 d内死亡的预后因素。结果:57例患者出院后90 d内死亡（45.2%，57/126）。Kaplan-Meier生存分析及单因素Cox比例风险模型分析结果显示，死亡组与生存组差异有统计学意义的项目包括患者年龄≥65岁、CRRT后12 h高乳酸值、肺部感染、肝功能障碍、存在永久性神经系统并发症、术后射血分数<45%（n P值均n <0.05）。将上述因素纳入多元Cox比例风险模型，结果显示，年龄≥65岁（n HR=2.14，95%n CI：1.09~4.21，n P=0.03）、CRRT后12 h高乳酸值（n HR=1.13，95%n CI：1.06~1.20，n P=0.01）、术后射血分数<45%（n HR=2.21，95%n CI：1.09~4.51，n P=0.03）是患者出院后90 d死亡的预后因素。n 结论:急性A型夹层术后发生急性肾损伤行CRRT的患者，出院后90 d内死亡的预后因素包括年龄≥65岁、CRRT后12 h高乳酸值、术后射血分数<45%，识别预后因素对提高此类患者的救治成功率可能有益。“,”Objective:To investigate the prognosis factors for death within 90 days after discharge in patients with acute kidney injury(AKI) treated requiring continuous renal replacement therapy(CRRT) undergoing surgery for acute Standford type A aortic dissection.Methods:The clinic data of 126 patients undergoing CRRT for postoperative AKI after acute type A aortic dissection surgery in the Center for Cardiac Intensive Care, Beijing Anzhen Hospital from July 2016 to February 2019 were analyzed retrospectively. There were 83 males and 43 females, aging(52.9±11.2) years(range: 25 to 70 years). The patients′ demographic characteristics, disease-related information, perioperative data, laboratory indexes during CRRT, complications, and survival information within 90 days after discharge were recorded. Independent prognosis factors for death within 90 days of discharge were determined by Kaplan-Meier survival analysis, univariate and multifactorial Cox regression analysis.Results:Totally 57 of 126 patients(45.2%) died over the first 90 days after discharge. Kaplan-Meier survival analysis and univariate Cox regression analysis showed that there were significant differences between the non-survival and survival group including ≥65 years old, high lactate values 12 hours after CRRT, pulmonary infection, liver dysfunction, presence of permanent neurological complications, and postoperative ejection fraction(EF)<45%. Multifactorial Cox regression analysis revealed that ≥65 years old(n HR=2.14, 95%n CI: 1.09 to 4.21, n P=0.03), high lactate values 12 hours after CRRT(n HR=1.13, 95%n CI: 1.06 to 1.20, n P=0.01) and postoperative EF<45%(n HR=2.21, 95%n CI: 1.09 to 4.51, n P=0.03) were independent prognosis factors for patients′ death within 90 days after hospital discharge.n Conclusions:≥65 years old, high lactate values 12 hours after CRRT and postoperative EF<45% are independent prognosis factors for death within 90 days after discharge in patients undergoing CRRT for AKI after acute type A aortic dissection surgery. Proper identification and management of prognosis factors could be beneficial to improve patients′ outcomes.