Linchuang shenzangbing zazhi (Jan 2015)

Clinical study of different hydration ways to prevent contrast induced nephropathy

  • XIE Yu-bo,
  • QUAN Li,
  • YANG Yong,
  • ZHANG Xiao-ming

Abstract

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Objective To compare different approaches of saline water supplement for the treatment and prevention of contrast induced nephropathy effects,so as to find the best water treatment method for the clinical therapeutic and improve the hydration effect of contrast induced nephropathy.Methods 150 cases of patients with coronary angiography or peripheral vascular angiography were randomly divided into an oral group,a peripheral intravenous group and a central venous channels group,50 cases each.Observe the three groups of patients urine,renal function,endogenous creatinine clearance rate,urine β2-microglobulin concentration of perioperative 1-5 days,evaluation of the adequate hydration treatment effects on cardiac function of bedside cardiac ultrasound at the same time.Results All patients with renal function serum creatinine and endogenous creatinine clearance rate,urine β2-microglobulin were to some extent increased compared with the preoperative,and the urine volume increased,serum creatinine level decreased,endogenous creatinine clearance rate and and urine β2-microglobulin concentrations recovered to the preoperative level over time.By means of central venous hydration therapy,serum creatinine,endogenous creatinine clearance rate and urine β2-MG 3days recovery,peripheral vein 5 days recovery of renal function,renal function recovery by the oral route at the latest.Three full hydration therapy does not affect the left ventricular end-systolic,end-diastolic volume,left ventricular ejection fraction was no statistical difference does not affect hemodynamics.Conclusions Three different ways to add hydration with normal saline may be effective prevention,treatment,contrast-induced nephropathy,without affecting cardiac function,but the central venous channel in patients with urine output and renal function recovery faster,method is simple,less trauma,the effect is best reliable efficacy.Three different ways of physiological saline water supplement can effectively prevent and treatment contrast induced nephropathy and not influence the heart function,but the urine volume and renal function recovery faster,the method is simple,less trauma,safe and reliable in the patients with center vein.

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