CAJ | 학술논문

目的：探讨不同方式的水化对对比剂肾病（CIN）发病率的影响，从而进一步证实水化在对比剂肾病预防中的地位。方法选择2009年12月至2010年8月在东南大学临床医学院附属徐州医院心内科住院行冠状动脉介入治疗患者90例，随机分为口服水化组、一般水化组和延长水化组；口服水化组术前6h到术后6h给予饮水1500mL、一般水化组术前6h到术后6h以1mL/(kg?h)速度给予0.9%；延长水化组术前6h到术后24h以1mL/(kg?h)速度给予0.9%生理盐水维持静滴；三组患者测定术前和术后48~72h之间血肌酐值。结果三组患者的对比剂肾病发病率不同，其中延长水化组发病率最低；一般水化组和延长水化组患者对比剂肾病发病率均较口服水化组低，且有统计学差异（P<0.05），但延长水化组患者对比剂肾病发病率与一般水化组相比无统计学差异（P>0.05）。结论冠脉造影或PCI术前和术后静脉滴注生理盐水的水化治疗较口服水化降低了患者对比剂肾病的发病率。
목적：탐토불동방식적수화대대비제신병（CIN）발병솔적영향，종이진일보증실수화재대비제신병예방중적지위。방법선택2009년12월지2010년8월재동남대학림상의학원부속서주의원심내과주원행관상동맥개입치료환자90례，수궤분위구복수화조、일반수화조화연장수화조；구복수화조술전6h도술후6h급여음수1500mL、일반수화조술전6h도술후6h이1mL/(kg?h)속도급여0.9%；연장수화조술전6h도술후24h이1mL/(kg?h)속도급여0.9%생리염수유지정적；삼조환자측정술전화술후48~72h지간혈기항치。결과삼조환자적대비제신병발병솔불동，기중연장수화조발병솔최저；일반수화조화연장수화조환자대비제신병발병솔균교구복수화조저，차유통계학차이（P<0.05），단연장수화조환자대비제신병발병솔여일반수화조상비무통계학차이（P>0.05）。결론관맥조영혹PCI술전화술후정맥적주생리염수적수화치료교구복수화강저료환자대비제신병적발병솔。
Objective To investigate the impact of different hydration on the morbidity of CIN . It is conifrmed that there is impact of hydration on the preventive status of CIN. Methods Ninety patients who accept percutaneous coronary intervention are selected from cardiology department of Xuzhou Hospital attached to southeast university clinical medical school from Dec 2009 to Aug 2010. The ninety patients are randomly divided into three groups, the oral hydration group, the general hydration group and the extended hydration group. The oral hydration group is treated with drinking water 1500mL between 6 hours before the surgery and 6 hours after the surgery. The general hydration group is treated with 0.9%normal saline to keep dripping at the speed of 1 mL/(kg?h) between 6 hours before the surgery and 6 hours after the surgery. The extended hydration group is treated with 0.9%normal saline to keep dripping at the speed of 1 mL/(kg?h) between 6 hours before the surgery and 24 hours after the surgery. All three groups receive the test of serum creatinine (Scr) and at the beginning and were tested again Scr level 48-72 hours after the surgery. Results The percentage of CIN is different between three groups:the extended hydration group has the lowest percentage;the general hydration group and the extended hydration group have the lower percentage than oral hydration group and there is signiifcant statistic difference (P<0.05). The general hydration group and the extended hydration group has no signiifcant statistic difference(P>0.05). Conclusion Hydration using 0.9%normal saline before and after cardiac angiography or PCI can help lower the percentage of CIN against hydration using drinking.