本文選題：增強(qiáng)CT + 口服水化�。� 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討對(duì)于CT增強(qiáng)檢查中腎功能正常的A、B兩組患者(A組無糖尿病、無高血壓;B組有糖尿病或高血壓),口服和靜脈兩種水化方式預(yù)防碘造影劑腎損傷的效果,為CT增強(qiáng)檢查中水化方式的選擇提供理論依據(jù)。對(duì)象與方法:選取2015.9-2017.1在我院行增強(qiáng)CT檢查符合納入和排除標(biāo)準(zhǔn)的患者126人,按照是否伴有糖尿病、高血壓分為A組(無糖尿病、無高血壓)64人、B組(有糖尿病或高血壓)62人。然后按將A組患者隨機(jī)分為A1組31人、A2組33人。B組患者隨機(jī)分為B1組32人、B2組30人。A1組與B1組實(shí)施口服水化方案,A2組與B2實(shí)施靜脈水化方案,具體分組:A1組(口服水化組)、A2組(靜脈水化組),B1組(口服水化組)、B2組(靜脈水化組)。收集所有患者CT增強(qiáng)前(24h以內(nèi))、增強(qiáng)后第1天、第3天、第7天的腎功能各指標(biāo)化驗(yàn)結(jié)果,包括α1微球蛋白(α1-Microglobulin)、β2微球蛋白(β2-Microglobulin)、胱抑素(Cystatin-C,Cys C)、肌酐(Serum creatinine,SCr)、尿素氮(Blood urea nitrogen,BUN),并根據(jù)造影劑腎病概念判定造影劑腎病發(fā)生率。比較A1、A2各組組內(nèi)增強(qiáng)前與增強(qiáng)后第1天、第3天、第7天腎功能各指標(biāo)變化情況及A1、A2兩組對(duì)應(yīng)時(shí)間(增強(qiáng)前、增強(qiáng)后1d、后3d、后7d)腎功能各指標(biāo)變化情況。分析B1、B2各組組內(nèi)增強(qiáng)前與增強(qiáng)后第1天、第3天、第7天腎功能各指標(biāo)變化情況及B1、B2兩組對(duì)應(yīng)時(shí)間(增強(qiáng)前、增強(qiáng)后1d、后3d、后7d)腎功能各指標(biāo)變化情況。比較A1與A2兩組造影劑腎病發(fā)生率,B1與B2兩組造影劑腎病發(fā)生率。采用SPSS20.0統(tǒng)計(jì)學(xué)軟件分析數(shù)據(jù),用到的方法有t檢驗(yàn),卡方檢驗(yàn),方差分析,檢驗(yàn)水準(zhǔn)α=0.05,以P0.05表示差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:1.A1組CT增強(qiáng)前與增強(qiáng)后各時(shí)間段腎功能各項(xiàng)指標(biāo)比較無統(tǒng)計(jì)學(xué)差異(p0.05)。2.A2組CT增強(qiáng)前與增強(qiáng)后各時(shí)間段腎功能各項(xiàng)指標(biāo)比較無統(tǒng)計(jì)學(xué)差異(p0.05)。3.A1、A2兩組組間CT增強(qiáng)前、后各時(shí)間段腎功能各項(xiàng)指標(biāo)比較無統(tǒng)計(jì)學(xué)差異(p0.05)。4.B1組CT增強(qiáng)前與增強(qiáng)后各時(shí)間段腎功能各項(xiàng)指標(biāo)比較無統(tǒng)計(jì)學(xué)差異,(p0.05)。5.B2組CT增強(qiáng)前與增強(qiáng)后各時(shí)間段腎功能各項(xiàng)指標(biāo)比較無統(tǒng)計(jì)學(xué)差異(p0.05)。6.B1、B2兩組組間CT增強(qiáng)前、后各時(shí)間段腎功能各項(xiàng)指標(biāo)比較無統(tǒng)計(jì)學(xué)差異(p0.05)。7.A1、A2兩組造影劑腎病發(fā)生率無統(tǒng)計(jì)學(xué)差異(p0.05)。8.B1、B2兩組造影劑腎病發(fā)生率無統(tǒng)計(jì)學(xué)差異(p0.05)。結(jié)論:1.對(duì)于行CT增強(qiáng)檢查的腎功能正�；颊�,口服水化方法與靜脈水化方法對(duì)預(yù)防非離子型碘造影劑所引起的腎損傷具有同等效果。2.相比靜脈水化,口服水化簡便易行,增加了患者舒適度,降低了醫(yī)療成本,值得在CT增強(qiáng)檢查中推廣使用。
[Abstract]:Objective: to investigate the effect of oral and intravenous hydration on the prevention of renal injury caused by iodine contrast agent in group A and group B without diabetes mellitus and hypertension in group A and group B with normal renal function during CT enhancement. To provide a theoretical basis for the selection of hydration mode in CT enhanced examination. Participants and methods: 126 patients with hypertension were divided into group A (no diabetes, 64 patients without hypertension) and group B (62 patients with diabetes mellitus or hypertension) according to whether they were accompanied by diabetes mellitus or not, according to 126 patients who met the criteria of inclusion and exclusion by contrast-enhanced CT in our hospital from January to July 2015.These patients were divided into two groups: no diabetes, no hypertension and no hypertension. Then the patients in group A were randomly divided into group A1 (group A 1, n = 31), group A 2 (n = 33), group B (n = 33), group B _ 1 (n = 32), group B _ 2 (n = 30), group A _ 1 and group B _ 1 (n = 30) were given oral hydration regimen and group A _ 2 and group B _ 2 were treated with intravenous hydration. They were divided into two groups: group A _ 1 (group A _ 2) (Group B _ 1) (Group B _ 1) (Group B _ 2). The renal function indexes were collected from all the patients within 24 hours before CT enhancement, and on the 1st, 3rd and 7th day after enhancement. It included 偽 1-microglobulin (尾 2-microglobulin), cystatin (cystatin), creatinine (creatinine), urea nitrogen (urea) urea nitrogenbun (BUNA). The incidence of contrast agent nephropathy was determined according to the concept of contrast agent nephropathy. To compare the changes of renal function indexes before and after enhancement in A1A 2 group and the corresponding time (before enhancement, 1 day after enhancement, 3 days after enhancement, 7 days after enhancement) and at the corresponding time (before enhancement, 1 day after enhancement, 3 days after enhancement, 7 days after enhancement). The changes of indexes of renal function before and after enhancement and the corresponding time (before enhancement, 1 d, 3 d, 7 d) of B1B 2 group were analyzed. The changes of renal function indexes were analyzed before, 1 day after enhancement, 3 days after enhancement and 7 days after enhancement. The incidence of contrast agent nephropathy in group A 1 and group A 2 was compared with that in group B 1 and group B 2. SPSS20.0 statistical software was used to analyze the data, the methods used were t-test, chi-square test, variance analysis, test level 偽 0.05, the difference was statistically significant with P0.05. Results there was no significant difference in renal function indexes before and after CT enhancement in group 1: 1. There was no significant difference in renal function indexes before and after CT enhancement in group A 2. There was no significant difference between group A 2 and group A 2 before and after CT enhancement, and there was no significant difference between group A 2 and group A 2 before CT enhancement. There was no statistical difference in the indexes of renal function between the groups before and after CT enhancement. There was no statistical difference between the indexes of renal function before and after CT enhancement. There was no significant difference in the indexes of renal function before and after CT enhancement in group P0.05. 5.B2. The indexes of renal function before and after CT enhancement in group B 1 were not significantly different from those in group B 1 before and after CT enhancement. There was no statistical difference between the two groups before CT enhancement. There was no significant difference in the incidence of contrast agent nephropathy between the two groups. There was no significant difference in the incidence of contrast agent nephropathy between the two groups. Conclusion 1. For patients with normal renal function after CT enhancement, oral hydration and intravenous hydration have the same effect on preventing renal injury caused by Nonionic iodine contrast agent. Compared with intravenous hydration, oral hydration is simple and easy, increases patient comfort, reduces medical cost, and is worth popularizing in CT enhanced examination.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473

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