从医生视角看基于案例的过度水化所致神经系统症状的临床特征与防范

doi:10.3761/j.issn.2096-7446.2025.08.018

Abstract

Abstract:

Hydration therapy is widely used in angiography，interventional procedures，and certain surgical operations，serving as the cornerstone for preventing and treating acute kidney injury induced by iodinated contrast media. It is cost-effective，simple，and efficacious. However，improper hydration practices by patients or unstandardized guidance from healthcare providers may lead to overhydration，resulting in electrolyte imbalances，cardiac or renal dysfunction，and even neurological symptoms. This article focuses on the often-overlooked clinical nursing issue of neurological symptoms caused by overhydration. From a medical perspective and with case-based analysis，it explores the current status，mechanism，diagnosis and differential diagnosis，nursing care，and preventive measures. The aim is to enhance awareness of hydration therapy risk assessment，standardize and refine health education contents，and ultimately improve the overall quality of hydration therapy.

Key words: Hydration Therapy, Iodinated Contrast Agent, Hyponatremia, Nervous System Symptoms, Emergency Nursing

SI Tong, ZHOU Yong, WANG Shuang. Clinical characteristics and prevention of neurological symptoms induced by overhydration based on cases：from a physician’s perspective[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 998-1002.

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[1]	陈韵岱, 陈纪言, 傅国胜, 等. 碘对比剂血管造影应用相关不良反应中国专家共识[J]. 中国介入心脏病学杂志, 2014, 22(6):341-348.
	Chen YD, Chen JY, Fu GS, et al. China expert consensus on adverse reactions related to iodine contrast angiography application[J]. Chin J Interv Cardiol, 2014, 22(6):341-348.
[2]	武杰, 杨金超, 刘焱. 心血管介入碘对比剂使用管理护理专家共识[J]. 中国循环杂志, 2021, 36(7):625-633.
	Wu J, Yang JC, Liu Y. Nurse expert consensus on management of iodine contrast media application in cardiovascular inter-vention[J]. Chin Circ J, 2021, 36(7):625-633.
[3]	张桂莲, 焦力群, 吴伟. 对比剂脑病中国专家共识2023[J]. 中国脑血管病杂志, 2024, 21(3):207-216.
	Zhang GL, Jiao LQ, Wu W. Chinese expert consensus on con-trast-induced encephalopathy 2023[J]. Chin J Cerebrovasc Dis, 2024, 21(3):207-216.
[4]	钞俊, 李洁欣, 邹文远. 碘对比剂过敏反应与临床应用现状及展望[J]. 中国老年保健医学, 2014, 12(6):79-81.
	Chao/Miao J, Li JX, Zou WY. Current situation and prospect of allergic reaction and clinical application of iodine contrast agent[J]. Chin J Geriatr Care, 2014, 12(6):79-81.
[5]	杨旭, 黄晓青, 华潞, 等. 52例冠状动脉造影患者非离子型含碘对比剂过敏不良反应分析[J]. 中国循环杂志, 2015, 30(8):741-743.
	Yang X, Huang XQ, Hua L, et al. Analysis of allergic adverse reaction caused by non-ionic iodinated contrast media in 52 patients with coronary angiography[J]. Chin Circ J, 2015, 30(8):741-743.
[6]	黄双, 冯明声, 李锐, 等. 国内外造影剂的最新研究进展[J]. 中国药学杂志, 2010, 45(16):1213-1217.
	Huang S, Feng MS, Li R, et al. Latest research progress of contrast agents at home and abroad[J]. Chin Pharm J, 2010, 45(16):1213-1217.
[7]	Li X, Chen J, Zhang L, et al. Clinical observation of the adver-se drug reactions caused by non-ionic iodinated contrast media:results from 109,255 cases who underwent enhanced CT exa-mination in Chongqing,China[J]. Br J Radiol, 2015, 88(1047):20140491.
[8]	Seeliger E, Sendeski M, Rihal CS, et al. Contrast-induced kid-ney injury:mechanisms,risk factors,and prevention[J]. Eur Heart J, 2012, 33(16):2007-2015. doi: 10.1093/eurheartj/ehr494 pmid: 22267241
[9]	Nash K, Hafeez A, Hou SS. Hospital-acquired renal insufficien-cy[J]. Am J Kidney Dis, 2002, 39(5):930-936.
[10]	陈适, 艾合买提江·吐乎提, 顾锋, 等. 内分泌相关低钠血症患者临床特征分析[J]. 中国实用内科杂志, 2013, 33(12):968-969.
	Chen S, Aihemaitijiang THT, Gu F, et al. Consultation on hyponatremia in endocrinology department of a general hos-pital:a clinical analysis[J]. Chin J Pract Intern Med, 2013, 33(12):968-969.
[11]	Sailer CO, Winzeler B, Nigro N, et al. Characteristics and out-comes of patients with profound hyponatraemia due to prima-ry polydipsia[J]. Clin Endocrinol, 2017, 87(5):492-499. doi: 10.1111/cen.13384 pmid: 28556237
[12]	中华医学会放射学分会放射护理专业委员会放射诊断护理学组. 影像科碘对比剂输注安全专家共识[J]. 介入放射学杂志, 2018, 27(8):707-712.
	Radiological Diagnostic Nursing Group of Radiological Nurs-ing Care Professional Committee of Radiology Branch of Chinese Medical Association. Expert consensus on the safety of iodine contrast agent infusion in imaging department[J]. J Intervent Radiol, 2018, 27(8):707-712.
[13]	中华医学会临床药学分会, 中国药学会医院药学专业委员会, 中华医学会肾脏病学分会. 碘对比剂诱导的急性肾损伤防治的专家共识[J]. 中华肾脏病杂志, 2022, 38(3):265-288. doi: 10.3760/cma.j.cn441217-20210909-00041
	Clinical Pharmacy Branch of Chinese Medical Association, Hospital Pharmacy Professional Committee of Chinese Phar-maceutical Association, Nephrology Branch of Chinese Medical Association. Expert consensus on prevention and treatment of iodinated contrast-induced acute kidney injury[J]. Chin J Ne-phrol, 2022, 38(3):265-288.
[14]	Chen YD, Hu SY, Liu Y, et al. Renal tolerability of iopromide and iodixanol in 562 renally impaired patients undergoing cardiac catheterisation:the DIRECT study[J]. EuroIntervention, 2012, 8(7):830-838.
[15]	刘立艳, 万业达, 李艳, 等. 口服水化治疗时机选择对预防造影剂肾病效果的研究[J]. 护士进修杂志, 2013, 28(9):773-775.
	Liu LY, Wan YD, Li Y, et al. Study on the choice of oral hydration treatment time for prevention of contrast induced nephropathy[J]. J Nurses Train, 2013, 28(9):773-775.
[16]	中华医学会内分泌学分会电解质紊乱学组. 低钠血症的中国专家共识[J]. 中华内分泌代谢杂志, 2023, 39(12):999-1009.
	Electrolyte Disorders Group of Endocrinology Branch of Chinese Medical Association. Chinese expert consensus on hy-ponatremia[J]. Chin J Endocrinol Metab, 2023, 39(12):999-1009.
[17]	Tormey WP, Carney M, Cuesta M, et al. Reference change values for sodium are ignored by the American and European treatment guidelines for hyponatremia[J]. Clin Chem, 2015, 61(12):1430-1432. doi: 10.1373/clinchem.2015.242602 pmid: 26152751

Clinical characteristics and prevention of neurological symptoms induced by overhydration based on cases：from a physician’s perspective

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