腺苷负荷试验核素心肌灌注显像检查的观察和护理

Observation and Nursing of Adenosine 99mTc-MIBI Myocardial Perfusion Imaging Single Photon Emission Computed Tomography

目的探讨腺苷负荷试验核素心肌灌注显像检查方法的观察要点及护理。方法 204例患者经肘静脉持续静脉泵注入腺苷,剂量为140 g/(kg.min),用药时间为6 min。腺苷泵入3 min时静脉推注99mTc-MIBI(甲氧基异丁基乙腈)740 925 MBq,1.0 1.5 h后进行心肌断层显像,次日行静息心肌显像。在注射前、第3分钟、注射终止时和终止后5 min分别记录1次12导联心电图和血压,注射过程中严密观察患者不良反应、呼吸、心率、血压变化并做好护理记录,根据患者反应情况及时判断处理。结果共有165例患者出现不良反应,发生率80.88%,39例无任何不适反应占19.12%。204例患者全部安全通过试验,无严重并发症发生。结论腺苷负荷试验核素心肌灌注显像检查为心血管疾病的诊断提供可靠依据,不良反应常见,但反应较轻微,于终止试验后不良反应迅速消失,无重大不良反应发生,操作简便,安全性较高,且良好的护理方法对该实验的安全性具有重要的保障,值得推广。

Objective To investigate the main points of observation and nursing of adenosine-99mTc-MIBI myocardial perfusion single photon emission computed tomography（SPECT）.Methods A total of 204 patients were included in this study.Adenosine was infused intravenously at a rate of 140（g/（kg min） for 6 minutes,and 925MBq of 99mTc-MIBI740 was injected intravenously at 3 minutes after adenosine infusion.SPECT myocardial imaging acquisition was obtained in 1.0-1.5 hours after adenosine infusion.Rest myocardial perfusion imaging would be performed next day.12-lead electrocardiogram（ECG） and blood pressure were recorded at 3 minutes before injection,end and 5 minutes after injection.Adverse reaction,respiration,heart rate and blood pressure of the patients were observed during the procedure.Results Up to 165 patients had adverse reaction,accounting for 80.9%,the main symptoms included chest pain,chest tightness,palpitation,flush of the face,dizzy,headache,abdominal discomfort and nausea,other symptoms included hypodynamia and neck discomfort,40 patients had no adverse reaction,accounting for 19.1%.All operations were done successfully without serious complications.Conclusion Adenosine-99mTc-MIBI myocardial perfusion single photon emission computed tomography could provide reliable basis for the diagnosis of cardiovascular diseases.Although adenosine burden test has some adverse reactions,they vanishes quickly after stopping adenosine infusion,and there were no serious adverse reactions.This method is easy to operate and safe,which is worth to be popularized,and good nursing could insure good outcome.