磺胺嘧啶银冷霜外敷与50%硫酸镁湿敷治疗碘对比剂外渗的效果比较
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摘要
目的对比磺胺嘧啶银冷霜外敷与50%硫酸镁湿敷治疗碘对比剂外渗的效果。方法选取88例行CT增强扫描发生碘对比剂外渗的患者,按严重程度分层,然后按照治疗方法分为2组。研究组44例给予磺胺嘧啶银冷霜外敷,对照组44例给予50%硫酸镁湿敷。治疗后48 h观察局部肢体疼痛和肿胀程度,评价干预效果。结果轻度外渗患者中,研究组痊愈率100.00%(25/25),对照组痊愈率92.00%(23/25),2组差异无统计学意义(P>0.05);中度外渗患者中,研究组痊愈率89.47%(17/19),高于对照组的68.42%(13/19),差异有统计学意义(P<0.05)。对照组4例患者出现皮肤水泡。结论磺胺嘧啶银冷霜外敷能有效促进碘对比剂外渗导致的皮肤组织肿胀消退,缓解疼痛,在治疗中度外渗患者中优势较50%硫酸镁湿敷明显。
Objective To compare the clinical efficacy between silver sulfadiazine cream and magnesium sulfate solution in treatment of side effects caused by iodinated contrast media extravasation. Methods Totally 88 patients with iodinated contrast media extravasation during CT contrast-enhanced scan were divided into two groups according to the treatment received. Patients in the observation group(n=44) were given external application of silver sulfadiazine cream, and those in the control group(n=44) received wet compression of magnesium sulfate 50% solution. The treatment efficacy in relieving pain and swelling was evaluated at 48 hours after interventions. Results In terms of low-grade extravasation of the contrast media, there were no significant difference in cure rate between two groups(100.00% vs. 92.00%, P>0.05). In terms of medium-grade extravasation of the contrast media, the cure rate in the observation group was higher than that in the control group(89.47% vs. 68.42%, P<0.05). Only 4 patients developed skin blister in the control group. Conclusion Compared with wet compression of magnesium sulfate 50% solution, the external application of silver sulfadiazine cream is more effective to relieve the pain and swelling in patients with medium-grade extravasation of iodinated contrast media.
Objective To compare the clinical efficacy between silver sulfadiazine cream and magnesium sulfate solution in treatment of side effects caused by iodinated contrast media extravasation. Methods Totally 88 patients with iodinated contrast media extravasation during CT contrast-enhanced scan were divided into two groups according to the treatment received. Patients in the observation group(n=44) were given external application of silver sulfadiazine cream, and those in the control group(n=44) received wet compression of magnesium sulfate 50% solution. The treatment efficacy in relieving pain and swelling was evaluated at 48 hours after interventions. Results In terms of low-grade extravasation of the contrast media, there were no significant difference in cure rate between two groups(100.00% vs. 92.00%, P>0.05). In terms of medium-grade extravasation of the contrast media, the cure rate in the observation group was higher than that in the control group(89.47% vs. 68.42%, P<0.05). Only 4 patients developed skin blister in the control group. Conclusion Compared with wet compression of magnesium sulfate 50% solution, the external application of silver sulfadiazine cream is more effective to relieve the pain and swelling in patients with medium-grade extravasation of iodinated contrast media.
引文
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[4] 郑小燕,蔡志恒,徐建萍.Y型与直型静脉留置针用于CT增强检查注射造影剂效果比较[J].护理学杂志,2015,30(22):52-53.
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[11] 李仲华,张华山,王乾魁.50%硫酸镁加适量激素治疗碘造影剂血管外渗漏[J].药学与临床研究,2010,18(6):552-553.
[12] 刘素萍.硫酸镁热敷治疗碘造影剂渗漏致肢体肿胀53例疗效观察[J].陕西医学杂志,2010,39(5):633.
[13] 欧卉.磺胺嘧啶银脂质水胶敷料治疗小面积皮肤缺损并伤口感染:生物相容性评价[J].中国组织工程研究,2015,19(21):3366-3370.
[14] 黎月玲,黄作君,廖国辉,等.磺胺嘧啶银凝胶与磺胺嘧啶银霜剂的体外抑菌比较[J].中国医院药学杂志,2010,30(11):965-966.
[15] 吴菁,陆勇,陈雅琴,等.碘对比剂外渗皮肤反应不同治疗方案的对照研究[J].中国医学计算机成像杂志,2012,18(3):276-279.
[2] 许翠爱,姜敏霞.螺旋CT增强扫描对比剂外漏的原因分析及预防[J].中国辐射卫生,2011,20(4):496-497.
[3] WIENBECK S,FISCHBACH R,KLOSKA S P,et al.Prospective Study of Access Site Complications of Automated Contrast Injection With Peripheral Venous Access in MDCT[J].AJR Am J Roentgenol,2010,195(4):825-829.
[4] 郑小燕,蔡志恒,徐建萍.Y型与直型静脉留置针用于CT增强检查注射造影剂效果比较[J].护理学杂志,2015,30(22):52-53.
[5] 王清.CT增强检查前进行预注射降低造影剂渗漏的效果观察[J].护理研究,2014,28(9A):3138-3139.
[6] CHEW F S.Extravasation of iodinated contrast medium during CT:self-assessment module[J].AJR Am J Roentgenol,2010,195(6_supplement):S80-S85.
[7] 姜红,肖金利,范占明.桡静脉穿刺碘对比剂外渗后两种护理措施效果评价[J].医学影像学杂志,2015,25(5):802-804.
[8] LIU Z Z,VIEGAS V U,PERLEWITZ A,et al.Iodinated contrast media differentially affect afferent and efferent arteriolar tone and reactivity in mice:a possible explanation for reduced glomerular filtration rate.[J].Radiology,2012,265(3):762-771.
[9] BROCKOW K,CHRISTIANSEN C,KANNY G,et al.Management of hypersensitivity reactions to iodinated contrast media[J].Allergy,2015,60(2):150-158.
[10] 贾静,仇晓溪.整体干预治疗造影剂大量渗漏致骨筋膜室综合征的个案研究[J].护理研究,2010,24(6):554-555.
[11] 李仲华,张华山,王乾魁.50%硫酸镁加适量激素治疗碘造影剂血管外渗漏[J].药学与临床研究,2010,18(6):552-553.
[12] 刘素萍.硫酸镁热敷治疗碘造影剂渗漏致肢体肿胀53例疗效观察[J].陕西医学杂志,2010,39(5):633.
[13] 欧卉.磺胺嘧啶银脂质水胶敷料治疗小面积皮肤缺损并伤口感染:生物相容性评价[J].中国组织工程研究,2015,19(21):3366-3370.
[14] 黎月玲,黄作君,廖国辉,等.磺胺嘧啶银凝胶与磺胺嘧啶银霜剂的体外抑菌比较[J].中国医院药学杂志,2010,30(11):965-966.
[15] 吴菁,陆勇,陈雅琴,等.碘对比剂外渗皮肤反应不同治疗方案的对照研究[J].中国医学计算机成像杂志,2012,18(3):276-279.