摘要
目的:探讨不同水化途径对造影剂肾病影响。方法:525例拟行血管造影术患者,随机分为经口、外周静脉、锁骨下静脉途径三组,每组175例,术前6h、术后6～8h分别通过上述三种途径补充生理盐水2000ml,观察三组患者术前、术后1～5d尿量、内生肌酐清除率(Ccr),血、尿β2-MG水平变化,同时行心脏超声评价心功能的变化。结果:(1)与术前比较,三组术后24h平均尿量、Ccr均有明显增加,血、尿肌酐,血、尿β2-MG水平明显下降;(2)与经口途径组、外周静脉组比较,锁骨下静脉组术后24h平均尿量[(1875.23±29.31)ml比(1987.65±35.95)ml比(2213.26±26.47)ml]、Ccr[(85.43±1.52)ml/min比(73.63±1.24)ml/min比(89.85±2.35)ml/min]水平明显增加,P均<0.05;(3)所有患者Ccr逐渐恢复至术前水平,锁骨下静脉途径组术后第3日恢复术前水平,恢复最快,经口途径组术后第5日尚未恢复术前水平,恢复最慢。结论:三种不同水化途径均可有效预防、治疗造影剂肾病,但锁骨下静脉途径肾功能恢复最快,效果最好。
Objective：To study influence of different hydration paths on nephropathy（CIN） induced by contrast.Methods：A total of 525 patients undergoing angiography were randomly and equally divided into oral group,peripheral vein group and subclavian vein group.A total of 2000 ml normal saline was supplied on 6 h before and 6~8 h after angiography through above three paths.Changes of 24 h urine volume,endogenous creatinine clearance rate（Ccr）,blood and urine β2-microglobulin（β2-MG）before and 1~5 d after angiography were observed in three groups.Results：（1） Compared with before angiography,there were significant increase in mean 24 h urine volume and Ccr,and significant decrease in levels of blood and urine creatinine,blood and urine β2-microglobulin（β2-MG）in three groups;（2）compared with oral group and peripheral vein group after angiography,there were significant increase in levels of 24h mean urine volume [（1875.23±29.31） ml vs.（1987.65±35.95） ml vs.（2213.26±26.47） ml],Ccr [（85.43±1.52） ml/min vs.（73.63±1.24） ml/min vs.（89.85±2.35） ml/min],P0.05 all;（3）Ccr of all patients gradually recovered to preoperative level and that of subclavian vein group recovered to preoperative level on 3rd d after angiography,was fastest,and Ccr of oral group didn′t recover to preoperative level on 5th d after angiography,was slowest.Conclusion：All three hydration methods can prevent and effectively treat nephropathy induced by contrast,and subclavian vein path possesses best effects and its renal function recovery is fastest.
出处
《心血管康复医学杂志》
CAS
2012年第2期188-191,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
血管造影术
造影剂
肾病
Angiography
Contrast media
Nephrosis
