摘要
目的 探讨全程精细化护理联合水化疗法在预防脑梗死患者血管造影术后对比剂肾病（CIN）
的应用。方法 将我科全程精细化护理联合水化疗法推行前（2019 年 1～2019 年 6 月）入组的行血管造影术
的脑梗死患者随机选取 230 例纳入对照组，予以常规护理；将该护理模式推行后（2019 年 7 月～2019 年 12
月）入组的行血管造影术的脑梗死患者随机选取 230 例纳入研究组。记录术前 24h 内及术后 24h 内，两组
患者液体出入量（口服补液入量、尿量）差异；比较两组患者 CIN 发生率、住院时间差异。结果 术前 24h
内及术后 24h 内，研究组患者口服补液入量、尿量均大于对照组（P＜0.05）；研究组患者 CIN 发生率低于
对照组（P＜0.05），且住院时间短于对照组（P＜0.05）。结论 全程精细化护理联合水化疗法有助于增加
行血管造影术的脑梗死患者围手术期液体出入量，降低 CIN 发生率，缩短住院时间，并改善其心理状态。
关键词： 全程；精细化；护理；水化疗法；预防；脑梗死；血管造影术；术后；对比剂肾病
Abstract
Objective To explore the application of whole course fine nursing combined with hydration
therapy in preventing post angiography contrast nephropathy (CIN) in patients with cerebral infarction. Methods
230 patients with cerebral infarction undergoing angiography who were enrolled in our department before the
implementation of the whole process fine nursing combined with hydration therapy (January 2019 to June 2019)
were randomly selected and included in the control group for routine nursing; After the implementation of the
nursing model (July 2019 December 2019), 230 patients with cerebral infarction undergoing angiography were
randomly selected and included in the study group. The difference of fluid intake and output (oral rehydration
intake and urine volume) between the two groups within 24 hours before operation and within 24 hours after
operation was recorded; The difference of CIN incidence and hospitalization time between the two groups was
compared. Results The intake of oral rehydration and urine volume of patients in the study group were higher than
those in the control group within 24 hours before operation and 24 hours after operation （P<0.05); The incidence
of CIN in the study group was lower than that in the control group (P＜0.05). Conclusion The whole process fine
nursing combined with hydration therapy is helpful to increase the perioperative fluid intake and output of cerebral
infarction patients undergoing angiography, reduce the incidence of CIN, shorten the length of hospital stay, and
improve their psychological status.
Key words： whole process; Refinement; nursing; Hydration therapy; prevention; Cerebral infarction;Angiography; Postoperative; Contrast nephropathy
参考文献 References
[1] 文婉玲,张永巍,杨志刚,等.数字减影血管造影评估急性脑梗死患者血管再通术预后的初步分析[J].中华神经科杂志,2015,48（5）:373-376.
[2] 李辉,刘兵,赵迎,等.老年患者冠状动脉造影术后对比剂肾病发生率及危险因素分析[J].中华老年医学杂志,2015,34（9）:935-938.
[3] 丁力,庄国红,丁飚.静脉水化和口服水化预防心功能不全 患 者 对 比 剂 肾 病 临 床 应 用 [J]. 介 入 放 射 学 杂志,2016,25（1）:15-18.
[4] 何燕,薛秒,王珊珊,等.精细化护理干预及多学科协作对住院结核患者外出检查口罩佩戴依从性的影响[J].中国感染控制杂志,2018,17（8）:717-719.
[5] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国无症状脑梗死诊治共识[J].中华神经科杂志,2018,51（9）:692-698.
[6] 李睿珂.整体身心调节联合规律运动对社区抑郁老年人心境及主观幸福感的影响[J].中国老年学杂志,2016,36（3）:678-679.
[7] 张鹏,杨世诚,付乃宽.普罗布考对经皮冠状动脉介入治疗术后造影剂肾病的预防作用[J].临床心血管病杂志,2015,31（11）:1163-1166.
[8] 秦雨晗,汤成春.造影剂肾病的研究进展[J].东南大学学报（医学版）,2019,38（4）:722-727.