大剂量静脉补液对造影剂肾损害的保护作用观察

目的：了解大剂量静脉补液对血管造影患者肾功能的保护作用。方法：随机观察了48例应用泛影葡胺进行静脉肾盂造影和肾血管造影的患者，其中19例在造影前后均给予大剂量静脉补液，另外29例为对照。于造影前及造影后第1、6天分别监测血肌酐（Scr)、内生肌酐清除率（Ccr)、血渗透压、尿渗透压、24h尿蛋白定量、尿常规。结果：在应用大剂量补液治疗的一组中，各观察指标造影前、后比较差异无显著性（P＞0．05），仅尿常规指标有加重者2例，均于造影后第6天恢复造影前水平。对照组于造影后第1天尿蛋白定量增加，Scr上升（P＜0．05），Ccr下降（P＜0．05），第6天复查基本恢复造影前水平，但有1例未能恢复。结论：大剂量静脉补液不但安全、易行，且可大大减少造影剂所造成的肾损害。

Protective effect of high-dose transfusion to contrast medium-induced nephropathy.

Objective To observe the protective effect of high dose transfusion to the renal function of patients with contract induced nephropathy.Methods Forty eighty patients undergoing pyelography or renal angiography with hypaque sodium were studied. Among them, 19 (treated group) were treated with high dose transfusion before and after operation and the remaining 29 patients served as control group. Before and 1, 6 days after operation, serum creatinine (Scr), endogenous creatinine clearance rate (Ccr), osmotic pressur in blood and urine, 24 h urine protein were monitored and urine routine test was done.Results The changes of monitored factors in treated group wer not significant, only 2 patients showed aggravated mark in urine routine test, but they recovered at day 6 after operation. Patients in control group 1 day after operation showed an increased level of 24 h urine protein and Scr, and a decreased level of Ccr, they recovered at day 6 after operation on the whole except one patient.Conclusion high dose transfusion is a safe and easy therapy to patients undergoing pyelography or renal angiography, and can reduce the contract induced damage to kidney.