CT增强扫描时大量造影剂外溢原因分析及防治措施
|
摘要
目的探讨CT增强扫描时大量造影剂外溢的原因及防治措施。方法选取2013年7月～2015年11月于首都医科大学附属北京世纪坛医院行CT增强扫描的患者2500例,观察扫描时是否出现大量造影剂外溢情况,针对造影剂外溢原因进行单因素描述分析和多因素Logistic回归分析,并探讨预防措施。结果 2500例患者经CT增强扫描,其中21例(0.84%)存在大量造影剂外溢情况。单因素分析发现年龄、疾病类型、注射血管部位、注射流速、渗透压、患者依从性及护士操作技术不熟练等与大量造影剂外溢有关(P <0.05)。多因素Logistic回归分析显示,年龄(OR=1.825)、疾病类型(OR=2.054)、注射流速(OR=3.024)、渗透压(OR=2.687)、依从性(OR=1.953)及护士操作技术(OR=2.547)为大量造影剂外溢的独立危险因素。结论 CT扫描时大量造影剂外溢影响因素存在相互作用,应针对相关因素加强护理干预并提升穿刺技巧,提高增强扫描安全性。
Objective To explore the causes and preventive measures of a large number of contrast agent overflowing in CT enhanced scanning. Methods A total of 2500 patients with CT enhanced scan in Beijing Shijitan Hospital, Capital Medical University from July 2013 to November 2015 were selected to observe whether a large number of contrast agent spillovers appeared during the scan. Through single factor description analysis and multivariate Logistic regression analysis, the causes of contrast agent overflow were analyzed, and preventive measures were discussed. Results A large number of contrast agent overflows were found in 21(0.84%) of 2500 patients after CT enhanced scan. Single factor analysis showed that in the age, disease typ, injection vessel site, injection velocity, osmotic pressure, poor compliance of patients and nurses are not skilled were related to a large number of contrast agent overflowing(P < 0.05). Multivariate Logistic regression analysis showed that age(OR = 1.825), disease type(OR = 2.054), injection velocity(OR =3.024) and osmotic pressure(OR = 2.687), Compliance(OR = 1.953) and skill level of nurses(OR = 2.547) were independent risk factors affecting the extravasation of a large number of contrast agents. Conclusion The influence factors of a large number of contrast agent spillovers in CT scan are interacted. Strengthening nursing intervention according to the related factors, improve the skill of puncture, improve the security of enhanced scan.
Objective To explore the causes and preventive measures of a large number of contrast agent overflowing in CT enhanced scanning. Methods A total of 2500 patients with CT enhanced scan in Beijing Shijitan Hospital, Capital Medical University from July 2013 to November 2015 were selected to observe whether a large number of contrast agent spillovers appeared during the scan. Through single factor description analysis and multivariate Logistic regression analysis, the causes of contrast agent overflow were analyzed, and preventive measures were discussed. Results A large number of contrast agent overflows were found in 21(0.84%) of 2500 patients after CT enhanced scan. Single factor analysis showed that in the age, disease typ, injection vessel site, injection velocity, osmotic pressure, poor compliance of patients and nurses are not skilled were related to a large number of contrast agent overflowing(P < 0.05). Multivariate Logistic regression analysis showed that age(OR = 1.825), disease type(OR = 2.054), injection velocity(OR =3.024) and osmotic pressure(OR = 2.687), Compliance(OR = 1.953) and skill level of nurses(OR = 2.547) were independent risk factors affecting the extravasation of a large number of contrast agents. Conclusion The influence factors of a large number of contrast agent spillovers in CT scan are interacted. Strengthening nursing intervention according to the related factors, improve the skill of puncture, improve the security of enhanced scan.
引文
[1]薛永春.CT增强扫描造影剂渗漏的预防及护理分析[J].心理医生,2016,22(1):178-179.
[2]张娟,陈金凤.综合性护理措施在降低CT增强扫描造影剂不良反应发生率中的应用[J].临床与病理杂志,2016,36(7):929-934.
[3]姜琳莉.加强护理干预在预防CT增强扫描造影剂外渗中的效果[J].当代医学,2015,21(35):117-118.
[4] Kawanaka Y,Kitajima K,Fukushima K,et al. Added value of pretreatment(18)F-FDG PET/CT for staging of advanced gastric cancer:comparison with contrast-enhanced MDCT[J]. Eur J Radiol,2016,85(5):989-895.
[5]陆皓,王丹,许国辉,等.碘造影剂在CT扫描时发生渗漏的影响因素及预防措施[J].现代仪器与医疗,2015,(5):118-119.
[6]王超琴.造影剂外渗部位与组织损伤程度关系研究[J].医药论坛杂志,2008,29(8):29-30.
[7]陈威.海藻酸钠微球与碘化油介入栓塞治疗转移性肝癌的临床研究[D].石家庄:河北医科大学,2015.
[8] Shimonobo T,Funama Y,Utsunomiya D,et al. Low-tubevoltage selection for non-contrast-enhanced CT:comparison of the radiation dose in pediatric and adult phantoms[J].Phys Med,2016,32(1):197-201.
[9]刘一筠.离子型和非离子型造影剂在CT增强扫描中的应用效果观察及护理[J].蚌埠医学院学报,2014,(8):1137-1139.
[10]王萍,时惠平,马晓璇,等.探讨CT增强扫描中不同穿刺部位血管外渗探测技术的应用价值[J].中国医学装备,2014(4):47-49.
[11]耿旭,刘海霞,孙静华.CT增强扫描碘造影剂不良反应的预防及护理[J].护士进修杂志,2013,9(15):1390-1391.
[12] Lasnon C,Quak E,Briand M,et al. Contrast-enhanced smallanimal PET/CT in cancer research:strong improvement of diagnostic accuracy without significant alteration of quantitative accuracy and NEMA NU 4-2008 image quality parameters[J]. Ejnmmi Res,2013,3(1):5.
[13]孙青,李彩梅.静脉留置针预防高压注射器造影剂外渗效果观察与护理[J].齐鲁护理杂志,2012,18(1):91-92.
[14]侯晓丹.门诊CT检查者注射造影剂外渗后心理干预的效果分析[J].福建医药杂志,2012,34(5):152-153.
[15]祝红线,宋云龙,樊红霞,等.CT增强扫描对比剂渗漏与注射速率的相关性及预防措施[J].中国医学装备,2012,9(11):40-42.
[16]张灵敏.64排CT增强扫描中规范化护理流程的应用[J].医疗装备,2016,29(1):184-185.
[17]赵春生,姜继国,董肇宁.综合性护理干预对预防CT强化扫描中造影剂副反应的影响[J].护理实践与研究,2015(10):14-16.
[18]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(25):3138-3139.
[19]郑桂芬.关于静脉留置针穿刺血管的选择与护理[J].世界最新医学信息文摘,2017(66):186-187.
[20]李兴,赵海燕.循证护理对CT强化扫描患者的影响[J].中国医药导报,2016,13(17):157-160.
[21]祝红线,李相生,王萍,等.血管外渗探测技术预防MSCT增强扫描中造影剂渗漏的效果观察[J].中国医学装备,2012,9(12):37-39.
[22]刘金梅.CT增强扫描碘造影剂不良反应的预防及护理干预[J].中国医药科学,2017,7(16):185-187.
[2]张娟,陈金凤.综合性护理措施在降低CT增强扫描造影剂不良反应发生率中的应用[J].临床与病理杂志,2016,36(7):929-934.
[3]姜琳莉.加强护理干预在预防CT增强扫描造影剂外渗中的效果[J].当代医学,2015,21(35):117-118.
[4] Kawanaka Y,Kitajima K,Fukushima K,et al. Added value of pretreatment(18)F-FDG PET/CT for staging of advanced gastric cancer:comparison with contrast-enhanced MDCT[J]. Eur J Radiol,2016,85(5):989-895.
[5]陆皓,王丹,许国辉,等.碘造影剂在CT扫描时发生渗漏的影响因素及预防措施[J].现代仪器与医疗,2015,(5):118-119.
[6]王超琴.造影剂外渗部位与组织损伤程度关系研究[J].医药论坛杂志,2008,29(8):29-30.
[7]陈威.海藻酸钠微球与碘化油介入栓塞治疗转移性肝癌的临床研究[D].石家庄:河北医科大学,2015.
[8] Shimonobo T,Funama Y,Utsunomiya D,et al. Low-tubevoltage selection for non-contrast-enhanced CT:comparison of the radiation dose in pediatric and adult phantoms[J].Phys Med,2016,32(1):197-201.
[9]刘一筠.离子型和非离子型造影剂在CT增强扫描中的应用效果观察及护理[J].蚌埠医学院学报,2014,(8):1137-1139.
[10]王萍,时惠平,马晓璇,等.探讨CT增强扫描中不同穿刺部位血管外渗探测技术的应用价值[J].中国医学装备,2014(4):47-49.
[11]耿旭,刘海霞,孙静华.CT增强扫描碘造影剂不良反应的预防及护理[J].护士进修杂志,2013,9(15):1390-1391.
[12] Lasnon C,Quak E,Briand M,et al. Contrast-enhanced smallanimal PET/CT in cancer research:strong improvement of diagnostic accuracy without significant alteration of quantitative accuracy and NEMA NU 4-2008 image quality parameters[J]. Ejnmmi Res,2013,3(1):5.
[13]孙青,李彩梅.静脉留置针预防高压注射器造影剂外渗效果观察与护理[J].齐鲁护理杂志,2012,18(1):91-92.
[14]侯晓丹.门诊CT检查者注射造影剂外渗后心理干预的效果分析[J].福建医药杂志,2012,34(5):152-153.
[15]祝红线,宋云龙,樊红霞,等.CT增强扫描对比剂渗漏与注射速率的相关性及预防措施[J].中国医学装备,2012,9(11):40-42.
[16]张灵敏.64排CT增强扫描中规范化护理流程的应用[J].医疗装备,2016,29(1):184-185.
[17]赵春生,姜继国,董肇宁.综合性护理干预对预防CT强化扫描中造影剂副反应的影响[J].护理实践与研究,2015(10):14-16.
[18]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(25):3138-3139.
[19]郑桂芬.关于静脉留置针穿刺血管的选择与护理[J].世界最新医学信息文摘,2017(66):186-187.
[20]李兴,赵海燕.循证护理对CT强化扫描患者的影响[J].中国医药导报,2016,13(17):157-160.
[21]祝红线,李相生,王萍,等.血管外渗探测技术预防MSCT增强扫描中造影剂渗漏的效果观察[J].中国医学装备,2012,9(12):37-39.
[22]刘金梅.CT增强扫描碘造影剂不良反应的预防及护理干预[J].中国医药科学,2017,7(16):185-187.