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目的 探讨临床护理路径(CNP)在水化方式预防造影剂肾病(CIN)患者中的应用价值.方法 选择进行选择性冠状动脉造影的166例患者,根据随机数字表法随机分为观察组和对照组各83例,实际纳入研究的观察组患者81例,对照组患者82例.两组患者在造影前后均应用水化治疗方案.对照组患者应用常规方法,观察组患者应用CNP指导下的水化治疗方案.比较两组患者住院时间、住院费用、术后并发症发生率及患者与家属满意度.结果 观察组患者术后CIN发生率为1.2％,低于对照组的9.8％,差异有统计学意义(x2=5.672,P＜0.05)；两组患者排尿困难、尿潴留、导尿发生率比较,差异无统计学意义(P＞0.05).观察组患者的住院时间及住院费用分别为(4.05±0.62)d,(12318.29 ±2408.63)元,均低于对照组的(4.89±0.87)d,(15 762.83±3 125.42)元,差异均有统计学意义(t分别为7.091,7.874;P ＜0.01).观察组患者及家属护理满意度评分分别为(24.43 ±4.87),(25.79±4.01)分,均高于对照组的(17.92 ±3.36),(18.24 ±3.12)分,差异均有统计学意义(t分别为9.943,13.425；P＜0.01).结论 CNP应用于水化方式预防造影剂肾病患者,有利于提高护理质量,降低CIN的发生率,减少住院时间及住院费用.

Objective To discuss the application value of clinical nursing pathway (CNP) on preventing contrast-induced nephropathy(CIN) in patients by hydration.Methods Totals of 166 patients who had selective coronary angiography were randomly divided in the observation group and the control group,each with 83 cases.Both groups received hydration treatment,and the control group used conventional methods while the observation group was under the guidance of CNP.Hospitalization duration and expense,post-operative complications and satisfaction rates were compared between two groups.Results The incidence rate of CIN was 1.2％ in the observation group and 9.8％ in the control group,with statistically significant difference (x2 =5.672,P ＜ 0.05).There were no statistically significant differences in dysuresia,uroschesis and incidence rate of catheterization between two groups (P ＞ 0.05).The hospitalization time and expense was respectively (4.05 ±0.62) d and (12318.29 ±2408.63) yuan in observation group,and (4.89 ±0.87)d and (15762.83 ±3125.42) yuan in the control group,with statistically significant differences (t =7.091,7.874,respectively; P ＜ 0.01).The satisfaction rates of patients and families were (24.43 ± 4.87) and (25.79 ±4.01) in the observation group,and (17.92 ± 3.36) and (18.24 ± 3.12) in the control group,and the differences were statistically significant (t =9.943,13.425,respectively; P ＜ 0.01).Conclusions CNP in hydration to prevent contrast-induced nephropathy can improve the quality of nursing,reduce the incidence of CIN as well as hospitalization time and expense.