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口服水化预防门诊高危人群对比剂肾病临床分析

, PP. 2228-2231

Keywords: 口服水化,对比剂肾病,高危人群,门诊患者

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Abstract:

目的针对伴有对比剂肾病(contrastinducednephropathy,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2000mL,第2、3天每天各饮水1500mL,自由饮水。②强化水化组(n=22),增强前1h内,饮水900mL;增强后3h,每小时饮水500mL;第2、3天每天饮水1500mL。③简易水化组(n=25),增强前1h内,饮水900mL;增强后0.5h内饮水500mL;第2、3天每天饮水1500mL。分别在注射对比剂准备阶段,注射后24、72h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(P>0.05),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。

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