羟苯磺酸钙对冠脉介入治疗并发造影剂肾病的疗效及护理

Effects of calcium dobesilate on contrast induced nephropathy in patients undergoing percutaneous coronary intervention and nursing care.

目的观察羟苯磺酸钙对伴有轻度肾功能不全的冠脉介入治疗患者肾功能和造影剂肾病(CIN)发生的影响,并分析总结护理措施。方法 218例伴有轻度肾功能不全的冠脉介入治疗患者分为水化组(A组)96例和羟苯磺酸钙+水化组(B组)122例,术前及术后第1天、第3天、第7天检测血肌酐(Scr)、尿素氮(BUN)、胱抑素C(CysC),计算肌酐清除率(Ccr),观察尿量并实施相应的护理措施。结果 A组有12例患者发生CIN,发生率为12.5%;B组有6例患者发生CIN,发生率为4.9%,两组比较差异有统计学意义(P=0.043)。术后第1天、第3天,A组患者BUN、Scr、CysC的结果较术前显著升高(P<0.05),Ccr的结果较术前明显降低(P<0.05)。与A组相比,B组患者BUN、Scr的结果在术后第1天、第3天显著降低(P<0.05),而Ccr的结果却显著升高(P<0.05)。结论羟苯磺酸钙联合水化治疗、精心的护理可以明显减少肾功能不全的冠脉介入治疗患者CIN的发生,并能有效的改善肾功能。

Objective To observe the effects of calcium dobesilate on the incidence of contrast induced ne- phropathy （CIN） and renal function in patients with mild renal insufficiency undergoing percutaneous coronary inter- vention （PCI）, and to analyzed and summarized the nursing care measures. Methods Two hundred and eighteen pa- tients with mild renal insufficiency undergoing PCI were divided into hydration treatment group （group A, n=96） and calcium dobesilate with hydration treatment group （group B, n=122）. Serum creatinine （Scr）, blood urea nitrogen （BUN） and cystatin C （CysC） were detected before PCI and on the 1^th, 3^rd, 7^th day after PCI. Creatinine clearance （Ccr） was cal- culated. Moreover, urine output was observed and appropriate care measures were implemented. Results Group A has 12 patients with CIN （12.5%）, group B has 6 patients with CIN （4.9%）, with statistically significant difference be- tween two groups （P=0.043）. The levels of BUN, Scr, CysC on the 1^th and 3^rd day after PCI in group A were signifi- cantly higher than those before PCI （P〈0.05）, and the levels of Ccr on the 1^th and 3^rd after PCI were significantly lower than those before PCI （P〈0.05）. Compared with group A, the levels of BUN, Scr on the 1^th and 3rd day after PCI significantly reduced （P〈0.05）, but the levels of Ccr on the 1^th and 3rd day after PCI were significantly in- creased （P〈0.05）. Conclusion Calcium dobesilate joint hydration treatment and careful nursing care can significant- ly reduce the incidence of CIN in patients with renal insufficiency undergoing PCI. And it also can effectively improve their renal fimction.