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目的探讨水化治疗对施行心脏介入手术患者造影剂肾病的防治作用。方法选择符合入选条件的患者107例,分为A(观察组)、B(对照组)两组。A组于手术前12h和手术后24h内静脉给予生理盐水和口服补液,进行手术前水化;B组常规饮水,不做特殊补液。手术前对所有患者常规进行肝肾功能、血糖、血脂、心脏超声等检查,术后复查肝肾功能。A组在水化开始前、手术结束时、术后24h和术后48h测血肌酐值;B组患者于手术开始前、手术结束时、术后24h和48h测定血肌酐值;比较两组患者CIN的发生率。结果 B组患者手术结束后24h血肌酐水平显著高于术前(P<0.05);两组相比,患者术后24h血肌酐水平差异具有统计学意义,B组明显高于A组;A组CIN发生率明显低于B组。结论水化治疗可明显降低心脏介入手术患者造影剂肾病的发生率,且简单易行。
Objective To investigate the preventive and therapeutic effects of hydration on contrast-induced nephropathy in patients undergoing cardiac intervention. Methods A total of 107 patients who met the inclusion criteria were divided into two groups: A (observation group) and B (control group). Group A received saline and oral rehydration intravenously 12 hours before surgery and 24 hours after surgery, and preoperative hydration. Group B received regular drinking water without special rehydration. All patients routine liver and kidney function, blood glucose, blood lipids, cardiac ultrasound and other tests before surgery, liver and kidney function after review. Blood creatinine was measured before the start of hydration, at the end of surgery, 24h after operation and 48h after operation in group A; the serum creatinine was measured before operation, at the end of operation and at 24h and 48h after operation in group B; CIN incidence. Results The level of serum creatinine in group B was significantly higher than that before operation at 24 hours after operation (P <0.05). The difference of serum creatinine in group B was significantly higher than that in group A CIN incidence was significantly lower than the B group. Conclusion Hydration therapy can significantly reduce the incidence of contrast agent nephropathy in patients undergoing cardiac intervention and is simple and easy to operate.