目的 观察羟苯磺酸钙对伴有轻度肾功能不全的冠脉介入治疗患者肾功能和造影剂肾病(CIN)发生的影响,并分析总结护理措施.方法 218 例伴有轻度肾功能不全的冠脉介入治疗患者分为水化组(A组)96 例和羟苯磺酸钙+水化组(B 组)122 例,术前及术后第1 天、第3 天、第7 天检测血肌酐(Scr)、尿素氮(BUN)、胱抑素C(CysC),计算肌酐清除率(Ccr),观察尿量并实施相应的护理措施.结果 A组有12 例患者发生CIN,发生率为12.5%;B组有6例患者发生CIN,发生率为4.9%,两组比较差异有统计学意义(P=0.043).术后第1天、第3天,A组患者BUN、Scr、CysC的结果较术前显著升高(P<0.05),Ccr的结果较术前明显降低(P<0.05).与A组相比,B组患者BUN、Scr的结果在术后第1天、第3天显著降低(P<0.05),而Ccr的结果却显著升高(P<0.05).结论 羟苯磺酸钙联合水化治疗、精心的护理可以明显减少肾功能不全的冠脉介入治疗患者CIN的发生,并能有效的改善肾功能.%Objective To observe the effects of calcium dobesilate on the incidence of contrast induced nephropathy (CIN) and renal function in patients with mild renal insufficiency undergoing percutaneous coronary intervention (PCI), and to analyzed and summarized the nursing care measures. Methods Two hundred and eighteen patients with mild renal insufficiency undergoing PCI were divided into hydration treatment group (group A, n=96) and calcium dobesilate with hydration treatment group (group B, n=122). Serum creatinine (Scr), blood urea nitrogen (BUN) and cystatin C (CysC) were detected before PCI and on the 1th, 3rd, 7th day after PCI. Creatinine clearance (Ccr) was calculated. Moreover, urine output was observed and appropriate care measures were implemented. Results Group A has 12 patients with CIN (12.5%), group B has 6 patients with CIN (4.9%), with statistically significant difference between two groups (P=0.043). The levels of BUN, Scr, CysC on the 1th and 3rd day after PCI in group A were significantly higher than those before PCI (P<0.05), and the levels of Ccr on the 1th and 3rd after PCI were significantly lower than those before PCI (P<0.05). Compared with group A, the levels of BUN, Scr on the 1th and 3rd day after PCI significantly reduced (P<0.05), but the levels of Ccr on the 1th and 3rd day after PCI were significantly increased (P<0.05). Conclusion Calcium dobesilate joint hydration treatment and careful nursing care can significantly reduce the incidence of CIN in patients with renal insufficiency undergoing PCI. And it also can effectively improve their renal function.
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