经导管动脉栓塞术中使用对比剂对肾功能的影响

Influence of contrast medium on renal function after transcatheter arterial embolization in bleeding patients caused by trauma

目的探讨经导管动脉栓塞术(TAE)术中使用对比剂对外伤患者肾功能的影响。方法回顾性分析因腹部或盆腔急性外伤而接受TAE的80例患者,比较其术前及术后血清肌酐水平。结果术前血清肌酐为(1.02±0.24)mg/dl,术后为(0.94±0.26)mg/dl,略低于术前(P=0.01)。肾衰竭高危患者TAE后血清肌酐总体水平无明显增高。术后5例(5/80,6.25%)发生对比剂肾病,对比剂肾病发生率的95%可信区间为2%～11%;血清肌酐水平均于术后5天内恢复至基线水平。结论外伤患者TAE后可能发生对比剂肾病,但多为一过性的,TAE中使用对比剂是较为安全的。

Objective To explore the influence of contrast agent on renal function in bleeding patients caused by trauma and treated with transcatheter arterial embolization （TAE）. Methods Eighty bleeding patients with abdominal or pelvic trauma underwent TAE were retrospectively analyzed, and whose serum creatinine level were observed pre-operatively and post-operatively. Results In 80 patients, the pre-operative serum creatinine was （l. 02±0. 24）mg/dl, and the post-opera- tive serum creatinine was （0.94±0.26）mg/dl, lower than the former （P=0.01）. In patients with renal failure, the level of serum creatinine did not obviously increase. Contrast-induced nephropathy occurred in 5 cases （5/80, 6.25 %）, the 95 % confidence interval of incidence rate was 2%-11%. The serum creatinine level went back to the baseline within 5 days. Conclusion Contrast-induced nephropathy may happen in traumatic bleeding patients after TAE, but it appears transiently for the majority patients, therefore the usage of contrast agent is safe.