冠心病患者对比剂诱发肾病的临床研究

为了比较两种水化方法对对比剂肾病(CIN)的影响,我们选住院行经皮冠状动脉介入治疗(PCI)94例肾功能不全患者,随机分为氯化钠水化组、碳酸氢钠水化组测定术后4天血肌酐水平变化。结果显示,氯化钠水化组6例发生CIN(13.3%),碳酸氢钠水化组3例CIN(6.3%),提示对于慢性肾功能不全患者碳酸氢钠水化方案更优。     

Nutrition and hydration: an analysis of the recent papal statement in the light of the Roman Catholic bioethical tradition.

This article discusses the unexpectedly firm stance professed by John Paul II on the provision of artificial nutrition and hydration to patients who are in a persistent vegetative state, and it implications on previously held standards of judging medical treatments. The traditional ordinary/extraordinary care distinction is assessed in light of complexities of the recent allocution as well as its impact on Catholic individuals and in Catholic health care facilities. Shannon concludes that the papal allocution infers that the average Catholic patient is incapable of making proper judgments about their own care. Shannon sees the preservation of life at all costs as at least highly troubling, if not as a radical move against the Catholic medical ethics tradition.     

Tube feedings and persistent vegetative state patients: ordinary or extraordinary means?

This article looks at the late John Paul II's allocution on artificial nutrition and hydration (ANH) and the implications his statement will have on the ordinary-extraordinary care distinction. The purpose of this article is threefold: first, to examine the medical condition of a persistent vegetative state (PVS); second, to examine and analyze the Catholic Church's tradition on the ordinary-extraordinary means distinction; and third, to analyze the ethics behind the pope's recent allocution in regards to PVS patients as a matter of conscience. Rather than providing clarification, I argue that the papal allocution has raised many difficult questions. People in situations where decisions must be made about withdrawal or continued ANH are in need of guidance. Moreover, additional analysis is needed to determine whether the papal allocution is in conflict with the traditional Catholic medical ethics understanding of the ordinary-extraordinary care distinction.     

The burdens-benefits ratio consideration for medical administration of nutrition and hydration to persons in the persistent vegetative state.

In this article, Harvey notes the initial confusion about the statement made by the pope concerning artificial nutrition and hydration on patients suffering persistent vegetative states (PVS) due to misunderstanding through the translation of the pope's words. He clarifies and assesses what was meant by the statement. He also discusses the problems of terminology concerned with the subject of PVS. Harvey concludes that the papal allocution was in line with traditional Catholic bioethics, and that while maintaining the life of a patient is favorable, in particular cases this presumption wanes when it is clear that this treatment modality would be futile or very burdensome.     

Withholding Hydration and Nutrition in Newborns

In the twenty-first century, decisions to withhold or withdraw life-supporting measures commonly precede death in the neonatal intensive care unit without major ethical controversy. However, caregivers often feel much greater turmoil with regard to stopping medical hydration and nutrition than they do when considering discontinuation of mechanical ventilation or circulatory support. Nevertheless, forgoing medical fluids and food represents a morally acceptable option as part of a carefully developed palliative care plan considering the infant’s prognosis and the burdens of continued treatment. Decisions to stop any form of life support should focus on the clinical circumstances, not the means used to sustain life.     

Stopping nutrition and hydration technologies: a conflict between traditional Catholic ethics and church authority.

This article focuses on the troubling effects of the secular values of individual freedom and autonomy and their impact on laws regarding suicide and euthanasia. The author argues that in an increasingly secularized culture, death and dying are losing their meaning and are not thought of within a moral framework. The debate regarding the provision of artificial nutrition and hydration is critically considered in light of the history of Catholic morality as well as within the modern healthcare context, and finally with new insight from the recent statements made by the late pope. Drane argues that the pope's insistence on providing artificial nutrition and hydration despite irreversible persistent vegetative states in unconvincing.     

两种水化疗法对预防对比剂肾病的效果研究

比较两种水化疗法对对比剂肾病(contrast-induced nephropathy,CIN)的预防效果。将150例患者随机分为氯化钠水化组(50例)、碳酸氢钠水化组(50例)和常规治疗组(50例),检测患者造影前3天内及造影后第3天、7天的血肌酐、尿素氮和尿β2微球蛋白。分析三组患者CIN的发病率。结果两水化组CIN的发病率均显著低于常规治疗组(P0.05),两水化组间CIN的发病率无明显差异(P0.05)。结果提示两种水化疗法对CIN的预防效果相仿。