CAJ | 학술논문

目的探讨充血性心衰患者心脏再同步化治疗(CRT)围手术期造影剂肾病(CIN)的预防及护理对策.方法选择我院收治行CRT的30例心衰患者,均采用术前及术后的水化治疗,并根据患者的肾功能采用不同的造影剂,严格控制造影剂剂量以及相应的预防及护理措施.结果 30例患者术后心功能均有改善,24例肾功能无变化,6例血肌酐升高,其中2例诊断为CIN,1例进展到尿毒症期并行血液透析治疗.结论术前仔细评估心肾功能,在围手术期采用水化及碱化治疗以及综合预防及护理措施可有效预防CIN.
목적 탐토충혈성심쇠환자심장재동보화치료(CRT)위수술기조영제신병(CIN)적예방급호리대책.방법 선택아원수치행CRT적30례심쇠환자,균채용술전급술후적수화치료,병근거환자적신공능채용불동적조영제,엄격공제조영제제량이급상응적예방급호리조시.결과 30례환자술후심공능균유개선,24례신공능무변화,6례혈기항승고,기중2례진단위CIN,1례진전도뇨독증기병행혈액투석치료.결론 술전자세평고심신공능,재위수술기채용수화급감화치료이급종합예방급호리조시가유효예방CIN.
Objective To explore the prevention and nursing strategies of contrast-induced nephropathy (CIN) in patients with congestive heart failure (CHF) within peri-operation period of cardiac resynchronization therapy (CRT). Methods Thirty inpatients with CHF from June 2007 to September 2009 were studied. All 30 patients received hydration therapy within peri-operation period and different contrast agents were administrated based on renal function of patients. The prevention and nursing measures, such as strictly limited the dosage of contrast agents were adopted. Results The heart function was significantly improved in all patients. There were no changes in renal function of 24 patients. However, 6 patients occurred the symptom of serum creatine increasing and 2 of whom was diagnosis as CIN and 1 patient degenerated into end stage renal function which relied on dialysis. Conclusions The comprehensive prevention and nursing measures including carefully evaluating renal function, taking the therapies of hydration and alkalization therapy can effectively prevent CIN for CHF patients receiving CRT.