不同温度对比剂在冠状动脉造影术中不良反应的对比观察

Adverse effects in coronary angiography:a comparative study of different temperature contrast medium

目的探讨进行冠状动脉造影检查时不同温度对比剂与受检者不适反应及心率、ST段、T波变化、手术时间、对比剂用量之间的关系。方法将患者随机分为常温组(521例)与温浴组(522例),常温组对比剂在室温情况下进行冠状动脉造影,温浴组将瓶装的对比剂放入恒定温度37℃水浴箱,60 min后按冠状动脉造影常规进行操作。观察两组患者术中心电监护所示ST段及T波、心率、早搏变化,T波振幅改变≥0.01 mv、ST段压低≥0.05 mv,心率改变≥10次/min纳入阳性统计,同时计算两组心慌、胸闷、胸痛不适反应发生率,统计手术时间、对比剂用量。结果两组间心率、ST、T波变化、手术时间差异有统计学意义(P≤0.05),两组间不适反应差异亦有统计学意义(P≤0.05)。结论水浴加热对比剂有助于预防冠脉造影检查术中不良反应。

Objective To investigate the correlation between different temperature contrast medium and the occurrence of adverse effects,including the chest discomfort,the changes of heart rate,ST segment and T wave,the operating time and the used dosage of contrast medium,in performing coronary angiography.Methods According to the contrast medium temperature used in coronary angiography,the patients were randomly divided into two groups： room temperature group（n = 521） and warm temperature group（n = 522）.The contrast medium used in warm temperature group was bathed in 37°C water for 60 minutes when the coronary angiography was carried out.The T wave amplitude changes ≥ 0.01 mv,ST segment depression ≥0.05 mv,changes in heart rate ≥ 10 times/min were brought into the positive accounting.The occurrence of adverse effects,such as palpitation,chest distress and pectoralgia,the operative time and the used dosage of contrast medium were recorded.The results were analyzed and compared between the two groups.Results Statistically significant differences in the changes of heart rate,ST segment deviation,T wave change and operating time existed between the two groups（P 0.05）.And the difference in the occurrence of adverse effects between the two groups was also statistically significant（P 0.05）.Conclusion When performing coronary angiography,warming of the contrast medium with water bath is greatly condusive to the prevention of cardiac adverse effects.