周围血管疾病介入围手术期水化实施和肾功能监测调查分析  

Investigation of the current situation regarding the implementation of hydration and renal function monitoring during perioperative period of peripheral vascular interventions

作　　者：刘佳莉 刘丽萍[2] 朱桦[1] LIU Jiali;LIU Liping;ZHU Hua(Department of Vascular Surgery,Department of Nursing,First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院血管外科,重庆400016 [2]重庆医科大学附属第一医院护理部,重庆400016

出　　处：《介入放射学杂志》2025年第1期91-95,共5页Journal of Interventional Radiology

基　　金：重庆市临床重点专科建设项目(精品项目-临床护理)(渝财社2023-47);重庆医科大学附属第一医院科研基金(HLJJ2020-31)。

摘　　要：目的调查分析周围血管疾病介入围手术期水化实施及肾功能监测临床实践现状,为有效预防对比剂肾病(contrast-induced nephropathy,CIN)提供依据。方法通过文献回顾、专家访谈和研究小组讨论设计调查问卷,并于2023年5月至6月采用“问卷星”形式对全国27个省(自治区/直辖市)141家医院医护人员进行现状调查。结果325名医护人员参与调查,其中84.92%(276/325)反馈实施水化疗法。265名医护人员反馈静脉水化情况:90.57%(240/265)选用0.9%氯化钠溶液,术前、术中、术后中位输液量均为1000 mL;239名医护人员反馈口服水化情况:56.07%(134/239)采取定量饮水方式,术前和术后6 h饮水量最少500 mL,最多2000 mL。受调查医护人员中10.15%(33/325)未监测血清肌酐,26.77%(87/325)未监测尿量。结论周围血管疾病介入围手术期临床水化方案不统一,肾功能监测不足。有必要加强对医护人员CIN预防知识学习,进一步探索既安全有效,又兼顾患者舒适、减轻临床负荷的水化策略。Objective To investigate and analyze the current situation regarding the implementation of hydration and renal function monitoring during perioperative period of peripheral vascular interventions,so as to provide references for effectively preventing contrast-induced nephropathy(CIN).Methods Through literature review,expert interview,and research group discussion,a survey questionnaire was designed.Using the"Wenjuanxing"platform,an investigation of the current situation about the implementation of hydration and renal function monitoring during perioperative period of peripheral vascular interventions was conducted among the medical staff of 141 hospitals in 27 provinces(autonomous regions/municipalities)from May to June of 2023.Results A total of 325 professionals participated in the survey,84.92%of whom(276/325)implemented hydration.A total of 265 medical workers gave feedback on intravenous hydration status:90.57%of them(240/265)adopted 0.9%sodium chloride solution,and the median volumes of infusion before,during and after surgery were all 1000 mL.A total of 239 medical workers gave feedback on oral hydration status:56.07%of them(134/239)adopted quantitative drinking water mode,the amount of drinking water varied from a minimum of 500 mL to a maximum of 2000 mL,which was given before surgery as well as within 6 hours after surgery.In addition,10.15%(33/325)of the respondents did not monitor creatinine levels,and 26.77%(87/325)of the respondents did not monitor urine volume.Conclusion At present,there is no unified hydration scheme during perioperative period of peripheral vascular interventions,and the monitoring of renal function is inadequate.It is necessary for medical staff to learn the knowledge of CIN prevention.At the same time,hydration strategies that are safe,effective,comfortable for patients and that can reduce the clinical workload of medical workers need to be further explored.

关 键 词：周围血管疾病 介入手术 对比剂肾病 水化疗法 肾功能监测 现状调查 

分 类 号：R473.6[医药卫生—护理学]