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纸质出版:2014
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程琳,姜晓梅,胡晓飞,刘晓玲,梁勇,王霞,王健.口服水化预防门诊高危人群对比剂肾病临床分析[J].陆军军医大学学报(原第三军医大学学报),2014,36(21):2228-2231.
Cheng Lin,Jiang Xiaomei,Hu Xiaofei,Liu Xiaoling,Liang Yong,Wang Xia,Wang Jian.Oral hydration therapy to prevent contrast-induced nephropathy for high risk out-patients: a clinical observation of 74 cases[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(21):2228-2231.
程琳,姜晓梅,胡晓飞,刘晓玲,梁勇,王霞,王健.口服水化预防门诊高危人群对比剂肾病临床分析[J].陆军军医大学学报(原第三军医大学学报),2014,36(21):2228-2231. DOI:
Cheng Lin,Jiang Xiaomei,Hu Xiaofei,Liu Xiaoling,Liang Yong,Wang Xia,Wang Jian.Oral hydration therapy to prevent contrast-induced nephropathy for high risk out-patients: a clinical observation of 74 cases[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(21):2228-2231. DOI:
目的 针对伴有对比剂肾病(contrast induced nephropathy,CIN)高危因素的门诊患者,设计3种不同的口服水化方案,监测使用对比剂后对肾脏功能的影响,寻找有效且简便易行的门诊水化措施。 方法 连续收集2011年1月至2013年9月门诊行增强CT扫描伴CIN高危因素的患者74例。男性45例,女性29例;年龄(63.79±8.81)岁。74例伴CIN高危因素的患者,根据水化量及水化时间分为:①常规水化组(n=27),增强当天饮水量2 000 mL,第2、3天每天各饮水1 500 mL,自由饮水。②强化水化组(n=22),增强前1 h内,饮水900 mL;增强后3 h,每小时饮水500 mL;第2、3天每天饮水1 500 mL。③简易水化组(n=25),增强前1 h内,饮水900 mL;增强后0.5 h内饮水500 mL;第2、3天每天饮水1 500 mL。分别在注射对比剂准备阶段,注射后24、72 h检查血清肌酐、尿素氮、血清半胱氨酸抑制酶C,运用单因素方差分析及重复测量设计的方差分析比较3组差异。 结果 3组水化方案均无CIN发生,重复测量设计的方差分析显示3组水化方案3个时间点血清肌酐、尿素氮、血清半胱氨酸抑制酶C水平在组内及组间差异均无统计学意义(P0.05),而其中简易水化方案所需时间最短,患者依从性最好。 结论 口服水化可以有效预防门诊高危因素人群的对比剂肾功能损害,但在3种方案中简易水化组方案最简便易行,最有利于门诊患者应用。
Objective To design 3 different oral hydration therapies for out-patients with high risk for contrast-induced nephropathy (CIN) who undergoing contrast-enhanced CT scanning and determine their preventive effects on renal function so as to explore an effective and simple measure to prevent CIN. Methods A total of 74 consecutive out-patients (45 males and 29 females
mean age 63.79±8.81) with high risk for CIN undergoing enhanced spiral CT scanning in our hospital from January 2011 to September 2013 were enrolled in this study. They were randomly divided into 3 groups
conventional hydration group (n=27
taking 2 000 mL water on the day of scanning and then 1 500 mL on the second and third days after that)
intensive hydration group (n=22
taking 900 mL water in 1 h before scanning
500 mL once per hour for 3 consecutive hours after scanning and then 1 500 mL on the second and third days after that) and trial hydration group (n=25
taking 900 mL water in 1 h before scanning
500 mL within 0.5 h after scanning and then 1 500 mL on the second and third days). Indexes including serum creatinine (Scr) level
serum urea nitrogen level and serum Cys C level of 3 groups were measured before and in 24 and 72 h after the injection of contrast
and the results were analyzed by variance analysis. Results No CIN was observed in the 3 groups. There was no significant difference in Scr level
serum urea nitrogen level and serum Cys C level at the 3 time points among the 3 groups (P0.05). But the trial hydration program required shorter time and got better compliance in the patients. Conclusion In clinical practice
the trial hydration therapy effectively prevents the renal impairment induced by contrast for the out-patients with high risk of CIN. Our trial hydration program is easy to follow and suitable for outpatients.
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