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目的如何综合防范对比剂肾病的发生。方法对105例患者全部进行水化处理,术后补液500～800 ml,使尿量>800 ml/2～4 h,如术后4 h内每小时尿量小于150 ml要及时处理,可应用小剂量利尿剂如速尿10～20 mg静脉注射,并监测肾功能变化,对比剂在术前1 h加温(将对比剂放置在37℃恒温箱中水溶加热)及选择等渗及低渗对比剂。结果在105例冠脉介入治疗患者中,均未发生对比剂肾病。结论术前进行科学的风险评估,进行充分的水化治疗或减少对比剂的使用量,尽量使用等渗对比剂,避免使用肾毒性药物等综合防范可大大降低对比剂肾病的发生。
How to comprehensively prevent the occurrence of contrast agent nephropathy. Methods All 105 patients were hydrated, and the amount of fluid rehydration was 500-800 ml. The urine output was more than 800 ml / 2-4 h. If the urinary output per hour was less than 150 ml within 4 hours after operation, it should be treated in time. Small doses of diuretics, such as furosemide 10 ~ 20 mg intravenously, and monitoring of renal function changes, contrast agents in the preoperative 1 h warming (the contrast agent placed in a 37 ° C incubator water heating) and select the isotonic and low permeability Contrast agent. Results In 105 patients with coronary intervention, no contrast nephropathy occurred. Conclusion Preoperative scientific risk assessment, adequate hydration therapy or reduce the use of contrast agent, try to use isotonic contrast agent, to avoid the use of nephrotoxic drugs and other comprehensive prevention can greatly reduce the incidence of contrast agent nephropathy.