充分水化疗法配合针对性护理对下肢动脉硬化闭塞症患者介入术后对比剂肾病的预防效果

Preventive effect of adequate hydration therapy combined with targeted nursing on contrast induced nephropathy in patients with lower extremity arteriosclerosis obliterans after interventional therapy

目的 探讨充分水化疗法配合针对性护理对下肢动脉硬化闭塞症(LEASO)患者介入术后对比剂肾病(CIN)的预防效果。方法 选取2021年7月至2023年3月温州医科大学附属第五医院(丽水市中心医院)收治的186例LEASO患者为研究对象,按照随机数字表法分为两组,每组93例。对照组给予常规护理干预,观察组给予充分水化疗法配合针对性护理。比较两组CIN发生率、临床相关指标、肾功能指标、行走能力和生活质量。结果 观察组CIN发生率低于对照组,肾功能恢复正常时间和住院时间均短于对照组,术后72 h尿量多于对照组,每日睡眠时间长于对照组,差异有统计学意义(P<0.05)。干预后,两组血尿素氮、血清肌酐和尿蛋白水平均高于干预前,但观察组低于对照组,差异有统计学意义(P<0.05)。干预后,两组行走受损问卷各维度评分、生活质量测定量表评分均高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论 LEASO患者采用充分水化疗法配合针对性护理能有效预防CIN发生,提高生活质量,值得临床推广应用。

Objective To explore preventive effect of adequate hydration therapy combined with targeted nursing on contrast induced nephropathy(CIN)after interventional therapy in patients with lower extremity arteriosclerosis obliterans(LEASO).Methods One hundred and eighty-six patients with LEASO admitted to the Fifth Affiliated Hospital of Wenzhou Medical University,Lishui Central Hospital from July 2021 to March 2023 were selected as study objects and divided into two groups according to random number table method,with 93 cases in each group.The control group was given routine nursing intervention,and observation group was given adequate hydration therapy combined with targeted nursing.Incidence rate of CIN,clinically relevant indicators,renal function indicators,walking ability,and quality of life between two groups were compared.Results Incidence rate of CIN in the observation group was lower than that in the control group,time of renal function recovery and hospitalization in the observation group were shorter than those in the control group,urine volume 72 hours after surgery in the observation group was higher than that in the control group,and daily sleep time in the observation group was longer than that in the control group,the differences were statistically significant(P<0.05).After intervention,levels of blood urea nitrogen,serum creatinine and urine protein in two groups were higher than before intervention,but those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).After intervention,scores of walking impairment questionnaire and World Health Organization quality of life in two groups were higher than before intervention,and those in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion Adequate hydration therapy combined with targeted nursing applied in LEASO patients can effectively prevent CIN and improve quality of life,it is worthy of clinical promotion and application.