对比剂急性肾损伤的风险评估及预防

介入技术的问世在为临床诊疗开辟新途径的同时,也伴随着对程序安全性的不断改善。不论是外周血管还是心脑血管介入,大多都需要在血管内施用对比剂,而对比剂的使用有引起急性肾损伤的风险,会产生主要并发症、延长住院时间、造成不良预后。本文聚焦对比剂造成的急性肾损伤这一临床问题,对其病理生理学、诊断、预测因素和临床处理进行综述,总结此类问题的风险处理策略。

Risk assessment and prevention of contrast-induced acute kidney injury:a review

The advent of interventional technology has generated new approaches to clinical diagnosis and treatment, and its develop-ment has also been accompanied by continuous improvements in procedure safety. Regardless of whether in peripheral vascular intervention or in cardiovascular and cerebrovascular intervention, intravascular administration of contrast agents is mostly required, and the use of contrast agents has the risk of causing acute kidney injury, leading to major complications, prolonged hospital stay, and poor prognosis. This article reviews the clinical problem of acute contrast-induced kidney injury in the respects of its pathophysiology, diagnosis, predictive factors, and clinical management, with a view to providing references in clinical decisions.