精细化短期强化饮水疗法预防冠状动脉介入术后患者造影剂相关急性肾损伤的效果  

Effect of refined short-term intensive drinking water therapy on the prevention of contrast-related acute kidney injury in patients after coronary intervention

作　　者：李孟岩 贾淑蕊 张娟 Li Meng-yan;Jia Shurui;Zhang Juan(Department of Interventional Medicine,People's Hospital of Jun County,Henan 456250,China;不详)

机构地区：[1]河南省浚县人民医院介入科,河南456250 [2]河南省浚县人民医院心血管内科,河南456250 [3]鹤壁市人民医院心血管内科

出　　处：《国际移植与血液净化杂志》2023年第1期22-25,共4页International Journal of Transplantation and Hemopurification

摘　　要：目的探讨冠状动脉介入手术患者术后不同饮水方法对预防造影剂相关性肾损伤的效果。方法选取河南省浚县人民医院介入科2021年1月至2022年3月期间收治的107例行冠状动脉介入手术治疗的患者,采用数字表法随机分为对照组(53例)和观察组(52例),分别采取常规术后增加饮水量法及精细化短期强化饮水疗法,对比两组患者术后出入量、血肌酐、血尿素氮、β_(2)微球蛋白水平以及造影剂相关急性肾损伤(CI-AKI)及二级终点事件发生情况。结果干预后,术后3 h、术后4~8 h及24 h总入量对照组小于观察组(P<0.05),术后4~8 h及24 h总出量观察组大于对照组(P<0.05),而术后3 h总出量两组间差异无统计学意义(P>0.05)。观察组血尿素氮高于干预前、血清β2微球蛋白低于干预前(P<0.05)。观察组血肌酐、血尿素氮、血清β2微球蛋白、CI-AKI及二级终点事件发生率均低于对照组(P<0.05)。结论精细化短期强化饮水方案能有效促进冠状动脉介入手术患者术后造影剂的排泄,有效保护肾功能,减少造影剂诱发急性肾损伤及二级终点事件发生率。Objective To investigate the effect of different drinking methods on preventing contrast-related renal injury in patients after coronary intervention.Methods A total of 107 patients who underwent coronary intervention in our department from January 2021 to March 2022 were selected as the research subjects and divided into the control group and the observation group according to the random number table method.53 cases in the control group were treated with routine postoperative increasing water intake therapy,while 52 cases in the observation group were treated with refined short-term intensive water intake therapy.The levels of serum creatinine(Scr),blood urea nitrogen(BUN),β_(2) microglobulin,contrast-related acute kidney injury(CI-AKI)and secondary endpoint events were compared between the two groups.Results After the intervention,the total intake volume of patients in the two groups at 3 h,4 to 8 h and 24 h after operation was significantly different,the control group was less than the observation group(P<0.05).The total output volume of patients in the control group at 3 h after operation was not significantly different(P>0.05).The total output volume of patients in the observation group at 4 to 8 h and 24 h after the operation was greater than the control group,and the difference was statistically significant(P<0.05).In the observation group,BUN was higher than that before intervention,and serumβ2 microglobulin was lower than that before intervention(P<0.05).The Scr,BUN and serumβ2 microglobulin of the observation group were lower than those of the control group.The incidences of CI-AKI and secondary end points were lower than those of the control group(P<0.05).Conclusion The refined short-term intensive drinking regimen can effectively promote the excretion of contrast media,effectively protect renal function,reduce the incidence of contrast-induced acute kidney injury and secondary end point events in patients with coronary intervention.

关 键 词：短期强化饮水 冠状动脉介入术 造影剂肾病 β_(2)微球蛋白 肾功能 

分 类 号：R541.4[医药卫生—心血管疾病] R692[医药卫生—内科学]