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目的探讨静脉滴注碳酸氢钠预防重症患者水化后造影剂肾病(CIN)的临床效果。方法将223例行增强CT检查的重症患者分为水化组(A组,86例)和水化情况下静脉滴注5%碳酸氢钠250ml组(B组,137例),检测检查前及增强CT后第1、2、3、5天的血清肌酐(SCr)和肾小球滤过率(GFR),比较两组的CIN发生率。结果与A组相比,B组增强CT检查后第2、5天SCr增加值较小,而第2、3、5天GFR增加值较大(P<0.05)。B组CIN的发生率低于A组(9.5%vs.30.2%)(P<0.05)。结论使用造影剂前,在水化的情况下使用碳酸氢钠能有效保护受检重症患者的肾功能。
Objective To investigate the clinical effect of intravenous infusion of sodium bicarbonate on prevention of contrast-induced nephropathy (CIN) in critically ill patients. Methods A total of 223 critically ill patients undergoing CT scan were divided into two groups: group A (n = 86) and group B (n = 137) treated with intravenous drip of 5% sodium bicarbonate under hydration conditions (group B, n = 137) Serum creatinine (SCr) and glomerular filtration rate (GFR) were increased at 1, 2, 3 and 5 days after CT, and the incidence of CIN was compared between the two groups. Results Compared with group A, the increase of SCr in group B on the second and fifth days was smaller than that in group A, while the increase of GFR was greater on the second, third and fifth day (P <0.05). The incidence of CIN in group B was lower than that in group A (9.5% vs.30.2%) (P <0.05). Conclusions The use of sodium bicarbonate in hydration prior to administration of contrast media effectively protects renal function in critically ill patients.