重度肾功能不全患者经皮冠状动脉介入术后有关造影剂肾病的病例分析

摘要

OBJECTIVE:To enhance the further understanding of the contrast-induced nephropathy, and to achieve early prevention and timely treatment .METHEDS:Analysis of cases study and related literature were conducted on 2 cases of contrast-induced nephropathy with severe renal insufficiency after PCI .RESULTS&CONCLUSIONS:2 patients were at high risk for the occurrence of contrast-induced nephropathy .One patient had no contrast-induced nephropathy because of the active prevention during coronary arteriography , while another patient got contrast-induced nephropathy without prevention . Contrast-induced nephropathy is a kind of iatrogenic renal damage .Through the risk stratification of patients , high-risk conditions can be conformed;suitable contrast agents with proper control of the dose and positive hydration of preventive intervention measures can reduce the occurrence of contrast-induced nephropathy in clinic .%目的：提高对造影剂肾病（ contrast agent nephropathy ，CAN）的进一步认识，做到早期预防和及时治疗。方法：对2例重度肾功能不全患者实施经皮冠状动脉介入术后有关CAN进行病例分析和相关文献分析。结果与结论：2例患者均属于CAN发生的高危人群，1例患者行冠状动脉造影术时给予积极预防CAN治疗，未发生CAN；而另1例患者未给予充分的预防CAN治疗，发生了CAN。 CAN是一种医源性的肾损害，通过对患者进行危险分层，明确高危状况，选择合适的造影剂及控制其剂量，积极给予水化等预防性干预等措施，临床上可减少CAN的发生。