高龄冠心病合并慢性肾功能不全患者行冠状动脉介入治疗后预防造影剂肾病的护理  

Nursing in prevention of contrast media induced nephropathy after percutaneous coronary artery intervention in senile coronary heart disease complicated with chronic renal insufficiency patients

作　　者：王娜[1] 董慧[1] 佟彦庆 王燕飞[1] WANG Na DONG Hui TONG Yan-qing et al.(Department of Cardiology, First Affiliated Hospital of Baotou Medical College, Baotou 014010, China)

机构地区：[1]包头医学院第一附属医院心内科,014010

出　　处：《中国实用医药》2017年第2期155-157,共3页China Practical Medicine

摘　　要：目的总结高龄冠心病合并慢性肾功能不全行经皮冠状动脉介入治疗(PCI)患者预防造影剂肾病(CIN)护理措施与体会。方法 86例CIN患者术前评价相关危险因素,做好术前、术后的水化治疗及术中造影剂的应用,严密观察生命体征,并精确记录24 h出入量,重视加强术前、术中及术后的护理。结果 86例患者术后并发CIN 12例,占14.0%;12例患者均应用了水化疗法,8例水疗7~9 d血清肌酐恢复正常范围,占66.7%,4例经血液透析3~4次血清肌酐恢复正常范围,占33.3%。结论术前、术中、术后应做好护理工作及增强水化治疗对高龄PCI术后CIN发生及改善预后非常重要。Objective To summarize nursing measure and experience in prevention of contrast media induced nephropathy（CIN） after percutaneous coronary artery intervention（PCI） in senile coronary heart disease complicated with chronic renal insufficiency patients. Methods Preoperative evaluation was made on related risk factors in 86 CIN patients. Rehydration therapy before and after operation and contrast media during operation were all applied properly. Vital signs were closely monitored. Detailed records were made on 24 h intake and output volume. Preoperative, intraoperative and postoperative nursing were given high attention. Results Among the 86 patients, there were 12 cases with postoperative complicated CIN, accounting for 14.0%. All the 12 cases received rehydration therapy. There were 8 cases with normal serum creatinine after 7~9 d of treatment, accounting for 66.7%, and 4 cases with normal serum creatinine after 3~4 d of treatment, accounting for 33.3%. Conclusion Proper implement of preoperative, intraoperative, postoperative nursing and enhancement of rehydration therapy are essential for occurrence and prognosis of CIN after PCI in senile patients.

关 键 词：造影剂肾病 慢性肾功能不全 冠心病 经皮冠状动脉介入治疗 高龄 水化治疗 护理 

分 类 号：R473[医药卫生—护理学]