摘要
目的随着放射诊断技术的不断发展和介入治疗的广泛应用,造影剂肾病(CIN)已成为医院内发生肾衰竭的第3位因素,水化是预防CIN的金标准,但在短时间内心脏病病人体内血容量增加明显,极易引起心力衰竭的发生,本文就PCI术后饮水对CIN的发生和体内血容量增加对心脏的影响的分析,探讨PCI术后标准化饮水方案。方法选择640例PCI术后患者,采用随机分组观察,将观察对象分为标准化饮水组320例和对照饮水组320例,观察饮水前和饮水后6 h内每小时的心率、血压、上腹饱胀感和饮水后1 h、2 h、3 h、4 h、5 h、6 h的尿量、造影术后24 h血肌酐、尿素氮、血清β2-微球蛋白的结果。结果标准化饮水组和对照饮水组饮水前和饮水后6 h内每小时的心率、血压和上腹饱胀感比较差异无统计学意义(P>0.05)。标准化饮水组术后1 h、2 h、3 h、4 h、5h、6 h的尿量明显多于对照饮水组,2组差异有统计学意义(P<0.01)。标准化饮水组造影术后24 h血肌酐、血尿素氮、血清β2-微球蛋白均明显低于对照饮水组,2组差异有统计学意义(P<0.01)。结论标准化饮水能有效预防CIN的发生,同时不会加重心脏、胃的负担,建议PCI术后给予标准化饮水。
Objective To analyze the influence of drinking water after percutaneous coronary intervention（ PCI） on the occurrence of contrast-induced nephropathy（ CIN）,and blood volume increases on the heart,and explore the standardization of drinking water after PCI. Methods 640 patients with PCI were enrolled and randomly divided into standardized group（ 320 cases） and control group（ 320 cases）. The heart rate,blood pressure and epigastric fullness were recorded before the drinking and 1h,2 h,3 h,4 h,5 h and 6 h after the drinking; the urine volume at 1h,2 h,3 h,4 h,5 h and 6 h after the drinking,the levels of serum creatinine,blood urea nitrogen and serum beta 2-microglobulin at 24 h after the angiography were tested. Results There were no statistical difference in the heart rate,blood pressure and epigastric fullness before the drinking and 1h,2 h,3 h,4 h,5 h and 6 h after the drinking between the two groups（ P〉0. 05）. The urine volume at 1h,2 h,3 h,4 h,5 h and 6 h after the drinking in the standardized group was obviously higher than that in the control group（ P〈0. 01）; the levels of serum creatinine,blood urea nitrogen and serum beta 2-microglobulin at 24 h after the angiography in the standardized group was obviously lower than those in the control group（ P〈0. 01）. Conclusion Standardization of drinking water after percutaneous coronary intervention can effectively prevent the occurrence of the CIN,and not increase the burden of the heart and stomach.
出处
《中华全科医学》
2015年第2期205-207,共3页
Chinese Journal of General Practice
关键词
PCI术后
标准化饮水
CIN
心衰
Percutaneous coronary intervention
Postoperative standardization of drinking water
Contrast-induced nephropathy
Heart failure
