不同饮水法对心脏介入治疗患者造影剂相关性肾损伤的影响

Observation on Different Drinking Methods to Prevent Contrast-induced Renal Impairment after Cardiac Intervention

目的探讨不同饮水方法对心脏介入治疗后造影剂相关性肾损伤的影响。方法选择2009年3—7月接受心脏介入治疗患者82例,分为常规水化护理组和强化水化护理组,记录术前及术后4 h内、13～24 h、手术当天24 h及术后第1、第2天入量和尿量,观察术后有无排尿困难、尿潴留、胃部不适等;检测造影前、造影后第3天、造影后第7天血浆肌酐水平及尿β2-微球蛋白水平,比较两组以上指标间的差异。结果强化水化护理组与常规水化护理组术后4 h、术后第1天、术后第2天入量比较差异有统计学意义(P<0.05),该3个时段的尿量比较差异有统计学意义(P<0.05)。造影前两组血浆肌酐及尿β2-微球蛋白水平差异无统计学意义(P>0.05);在造影后第3天及第7天比较,常规水化护理组高于强化水化护理组(P<0.05)。结论强化水化护理能有效降低心脏介入治疗造影剂引起的肾功能损害。

Objective To discuss the effect of different drinking methods on the prevention of contrast-induced renal impairment after cardiac intervention. Methods 82 patients with cardiac intervention from March to July in 2009 were divided into intensive hydration group and common hydration group. Intake and Output Volume was recording in different times before and after operation. Dysuria, urinary retention and discomfort in stomach were observed. Detections and comparisons were made about plasma creatinine level and β2-microglobulin （β2-MG） before and after angiography. Results There were of statistical significances of the comparisons about the whole intake and output volume within 4 hours and on the first and second day after angiography in two groups （P〈0.05）, while no statistical significance of the difference between plasma creatinine level and β2-microglobulin （β2-MG） before angiography （P〉0.05）. Meanwhile, there were higher plasma creatinine level and β2-microglobulin （β2-MG） on the third and seventh day after angiography in common hydration group （P〈0.05）. Conclusion Nursing with intensive hydration would effectively reduce contrast- induced renal impairment after cardiac intervention.