在接受皮肤冠状动脉干预的患者中预防对比诱导的病
Raymond Pranata1, Dendi Puji Wahyudi1
1Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia.
Current cardiology reviews
|October 25, 2023
概括
对比诱导性脏病 (CIN) 是皮肤冠状动脉干预 (PCI) 后的一个常见并发症. 风险分层和量身定制的预防策略,包括水化和对比介质的选择,对于管理CIN至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
背景情况:
- 对比诱导性脏病 (CIN) 是皮肤穿冠状动脉干预 (PCI) 后的一个显著并发症.
- 通过在对比介质给药后1-7天内血清肌素增加或尿液输出减少来定义CIN.
- CIN与PCI患者的死亡率增加有关.
研究的目的:
- 概述CIN. 的风险分层.
- 详细介绍CIN的预防策略.
- 强调根据个体患者的风险概况量身定制干预措施.
主要方法:
- 一般建议包括足够的水分,停止服用毒药物,以及手术前高强度他类药物.
- 对于EGFR<60毫升/分钟/1.73米2的患者,建议在手术前和后进行静脉注射水分.
- 具体的程序建议包括使用低/异体对比介质,限制体积,并采用辐射接入.
主要成果:
- 高风险患者可能会从额外的对比度节约技术中受益.
- 这些技术包括对比度降低系统,特定的导管类型和先进的成像指导.
- 也可以考虑先进的水化策略.
结论:
- 对PCI患者来说,CIN风险分层和量身定制的预防是必不可少的.
- 建议采用多方面的方法,包括补水,药物管理,对比选择和程序技术.
- 个性化CIN预防策略可以减轻风险并改善患者的治疗结果.
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