[1]杨 黄,倪志明,陆春来. 伽马刀治疗过程中对比剂肾损伤的防治[J].介入放射学杂志,2012,(09):743-746.
 YANG Huang,NI Zhi- ming,LU Chun- lai.. Prevention and treatment of contrast- induced acute kidney injury occurred during gammaray stereotactic radiosurgery[J].journal interventional radiology,2012,(09):743-746.
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 伽马刀治疗过程中对比剂肾损伤的防治 ()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2012年09期
页码:
743-746
栏目:
肿瘤介入
出版日期:
2012-09-30

文章信息/Info

Title:
 Prevention and treatment of contrast- induced acute kidney injury occurred during gammaray stereotactic radiosurgery
作者:
 杨 黄 倪志明 陆春来
Author(s):
 YANG Huang NI Zhi- ming LU Chun- lai.
 Department of Nephrology, No.85 Hospital of PLA, Shanghai 200052, China
关键词:
 【关键词】 急性肾损伤 立体定向放射治疗 危险因素
文献标志码:
A
摘要:
 【摘要】 目的 分析伽马刀治疗过程中急性肾损伤(AKI)的发病机制和危险因素,观察水化等干预治疗的防治作用。方法 收集2007年10月至2011年5月住院接受伽马刀治疗的体部肿瘤患者,其中100例(对照组)按照常规流程进行,100例(干预治疗组)采用水化、碱化、钙调等预防措施。观察两组AKI发生率、临床过程及转归。结果 对照组有18例AKI患者,均发生在造影后1 ~ 5 d,3例因少尿、高分解状态或高钾而进行血液透析1 ~ 3次。2周后所有患者的肾功能逐步改善,4周恢复至术前水平。干预治疗组有5例AKI,均发生在造影后48 h内,与对照组比较差异有统计学意义(P < 0.05)。与对照组相比,干预治疗组AKI表现较轻,无少尿,血清肌酐(Scr)、尿素氮(BUN)和尿酸升高,肾小球滤过率降低的变化幅度较低,1周时已恢复至术前水平,两组间差异有统计学意义(P < 0.05)。多元回归分析显示,高血压、糖尿病、高脂血症和Scr基础值偏高与AKI的发生密切相关;与年龄、性别和伽马刀治疗部位无显著相关性。结论 伽马刀治疗过程中发生的AKI主要与对比剂有关,而非放射性损伤所致。伴有糖尿病、高血压、高血脂、Scr基础值偏高者尤易发生。积极防治肾血管收缩能够防止和减轻AKI的发生和发展。 

参考文献/References:

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备注/Memo

备注/Memo:
 (收稿日期:2012-05-03)
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