强化护理联合碳酸氢钠水化对预防老年患者PCI造影剂肾损害的研究

Intensive care combined with hydration therapy with sodium bicarbonate prevents contrastinduced renal damage in elderly patients after percutaneous coronary intervention

目的研究强化护理联合碳酸氢钠水化疗法对预防老年冠脉介入手术(Percutaneous Coronary Intervention,PCI)患者造影剂肾损害(Contrast Induced Nephropathy,CIN)效果。方法 2008年9月-2009年5月行冠脉造影及介入治疗老年冠心病行碳酸氢钠水化疗法患者119例,分为强化护理组和常规护理组并比较造影前后肌酐变化。结果 119例患者均成功完成介入手术,围手术期无严重心血管事件发生。强化护理组1例、常规护理组5例出现肾功能异常;强化护理组PCI术后24h血肌酐与术前比较有增高趋势,但无统计学意义;常规护理组PCI术后24h血肌酐水平显著高于术前;PCI术后24h常规护理组血肌酐水平较强化组升高(P<0.01)。结论强化护理联合碳酸氢钠水化疗法可明显减少肾损害的发生。

Objective To investigate the effect of intensive care combined with hydration therapy with sodium bicarbonate on contrast-induced renal damage in elderly patients after percutaneous coronary intervention（PCI）.Methods One hundred and nineteen patients who underwent PCI and hydrated therapy with sodium bicarbonate in our hospital from September 2008 to May 2009 were randomly assigned to intensive care group and conventional care group.Changes in serum creatinine were compared between the two groups.Results All the patients underwent intervention operation with no cardiovascular events occurred.Renal dysfunction was found in 1 patient of intensive care group and in 4 patients of conventional care group.The serum creatinine level was higher in intensive care group 24h after PCI than before PCI and significantly higher in conventional care group than in intensive care group 24h after PCI（P0.01）.Conclusion Intensive care combined with hydration therapy with sodium bicarbonate can prevent contrastinduced renal damage in elderly patients after PCI.