胆道T管造影中对比剂注入方法对不良反应及周围血内毒素的影响

Effect of Contrast Medium Injection Methods on Adverse Reactions and Peripheral Blood Endotoxin in T-tube Cholangiography

目的探讨胆道T管造影术中采用不同对比剂注入方式对不良反应及周围血内毒素变化的影响。资料与方法对163例胆道术后患者行胆道T管造影,随机分为两组,即推注组和输注组。对两组患者出现的不良反应及周围血内毒素水平变化进行观察。结果两组均成功完成胆道造影;不良反应的发生在输注组明显减少(P<0.01),其中腹痛、发热两组有显著差别;胆道基础压力两组无差别,而推注组胆道内最高压力明显高于输注组(P<0.01);输注组血内毒素水平与术前相比差异无统计学意义(P>0.05),而推注组血内毒素水平比术前升高(P<0.01),术后两组周围血内毒素水平有显著性差异(P<0.05)。结论输注法胆道T型管造影同样可以成功进行胆道造影,胆道内压力波动小,对周围血内毒素水平影响小,且可降低不良反应发生率。

Objective To evaluate the effects of different contrast medium injection methods on adverse reactions and the level of endotoxin in biliary T tube angiography.Materials and Methods 163 patients with postoperative T-tube cholangiography were randomly divided into injection group and infusion group.The adverse reactions were observed and the levels of serum endotoxin were measured in pre-and post-operation.Results Cholangiographys were completed successfully in both groups.The incidence of adverse reactions decreased in infusion group compared with that of in injection group（P〈0.01）.Between the two group,the incidence of abdominal pain and fever were different significantly.The basis pressure in biliary tract of two groups has no difference,but the highest pressure in operation,injection group was significantly higher than infusion group（P〈0.01）.Compared with pre-operation,there was no difference with serum endotoxin level in infusion groups（P〉0.05）,while serum endotoxin level increased significantly in patients of injection group（P〈0.01）.There was significant difference of serum endotoxin level between two groups after T-tube cholangiography（P〈0.05）.Conclusion Cholangiography can be completed with infusion successfully.The change of pressure in biliary tract is smooth,and the influence to serum endotoxin level is slight with infusion method.The incidence of adverse reactions in this approach was decreased significantly compared with the commonly used injection method.