对比剂肾病的预防进展

发布时间：2018-11-16 16:34

【摘要】：近年来,伴随介入放射学、影像医学的快速发展,尤其是CT的普及及各种图像后处理技术的应用,碘对比剂的使用量逐年增加。碘具有不透X线的特性,基于这一性质,碘对比剂可注射于人体脉管系统,从而显示血管与体腔而帮助医生了解人体脉管结构及病变血供特点,并且造影后可大大提高影像诊断的准确率。但碘对比剂除了具有一系列速发型、迟发型不良反应外,尚可引起一种严重的并发症,即碘对比剂肾病。碘对比剂肾病是造影后3天内排除其他可能原因而引起的急性肾功能损伤,诊断主要根据血肌酐的变化来判断。有资料统计显示,对比剂肾病已成为继低血容量性休克、感染后医源性急性肾功能衰竭的第三大主要原因。对比剂肾病的病理生理机制尚不完全清楚,且无确切有效的治疗方法,因此其预防显得尤为重要。目前用于预防对比剂肾病的方法主要有危险因素评估与分层、停用肾毒性药物、充分水化、药物预防、血液透析与过滤等。本文就如何有效预防对比剂肾病这一问题搜集了国内外相关报道进行综述。
[Abstract]:In recent years, with the rapid development of interventional radiology and imaging medicine, especially the popularization of CT and the application of various image post-processing techniques, the use of iodine contrast agent has increased year by year. Iodine has the characteristic of impermeable X-ray, and based on this property, iodine contrast agent can be injected into the vascular system of human body, which can show blood vessels and body cavity and help doctors to understand the structure of human vessels and the characteristics of blood supply of pathological changes. And the accuracy of imaging diagnosis can be greatly improved after angiography. In addition to a series of rapid and delayed adverse reactions, iodine contrast agent can cause a serious complication, I. E. iodine contrast agent nephropathy. Iodine contrast agent nephropathy is an acute renal function injury caused by exclusion of other possible causes within 3 days after angiography. The diagnosis is mainly based on the changes of serum creatinine. According to statistics, contrast nephropathy has become the third major cause of iatrogenic acute renal failure following hypovolemic shock and infection. The pathophysiological mechanism of contrast-agent nephropathy is not fully understood, and there is no effective treatment, so its prevention is particularly important. At present, the main methods used to prevent contrast-agent nephropathy are risk factor assessment and stratification, discontinuation of nephrotoxic drugs, adequate hydration, drug prevention, hemodialysis and filtration, etc. This article reviews the effective prevention of contrast-agent nephropathy.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R692

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