荧光素钠眼底造影致存在基础疾病患者不良反应的临床特点分析

Analysis on adverse reactions of fluorescein sodium for fundus fluorescein angiography in patients with chronic diseases

目的观察存在基础疾病患者荧光素钠眼底荧光血管造影过程中不良反应的临床特征,指导临床正确处理和完成操作。方法收集我院2009年1月-2011年12月眼科门诊眼底造影患者3 000例。所有患者均接受皮试,20 min后观察患者反应,若无反应,口服胃复安10 mg、扑尔敏4 mg,进行造影。20%荧光素钠3 mL,2 s内静脉注射完毕,观察患者的不良反应。根据患者病史,将不良反应患者分为基础疾病组(糖尿病、高血压、冠心病、肺心病等)及无基础疾病组。结果临床观察3 000例患者,注射荧光素钠后发生不良反应96例,其中基础疾病组66例,无基础疾病组30例,基础疾病组与无基础疾病组患者的性别构成比较差异无统计学意义(P<0.05),基础疾病组患者多数为老年人(P<0.05),存在基础疾病患者的不良反应构成与无基础疾病患者的临床表现构成差异无统计学意义(P>0.05),两组患者多以消化道症状为主;不良反应的程度差异有统计学意义(P<0.05),无基础疾病的患者可能出现中、重度不良反应的比例较高。结论基础疾病患者在行荧光素钠造影时,发生不良反应多为老年患者,但临床反应较轻,多以消化道症状为主,无基础疾病患者出现不良反应的程度较重。

Objective To observe the adverse reactions of fluorescein sodium for fundus fluorescein angiography in patients with chronic diseases and guide the correct operation. Methods 3 000 patients were collected for fundus fluorescein angiography （FFA） using fluorescein sodium in our out-patient department of ophtalmology from January 2009 to December 2012. All patients received skin tests, and adverse reactions were observed after 20 minutes. If patients had no adverse reaction ,then the patients were given metoclopramide 10 mg, chlorpheniramine 4 mg. 20% fluo- rescein sodium 3 mL was injected in 2 s, and the adverse reactions were observed. The patients with adverse reactions were divided into chronic disease groups and no chronic disease groups according to their medical history. Results There were 96 patients with adverse reactions among 3 000 patients for FFA using fluorescein sodium. There were 66 patients in chronic diseases group and 30 patients in no chronic disease group. There was no significant difference in gender ratios between the two groups（ P 〉 0.05 ）. Most patients in chronic diseases group were old patients（ P 〈 0. 05 ）. There was no significant difference in the structure of clinical features between the two groups （ P 〉 0. 05 ）. The major clinical features were digestive tract reactions, such as nausea or vomiting. There were significant differences about the degree of adverse reactions between the two groups （ P 〈 0. 05 ）. There were high proportional midrange and severe pa- tients in no chronic diseases group. Conclusion There are a lot of old patients having adverse reactions in FFA using fluorescein sodium. But the degree of adverse reaction are mild. The major clinical feature are digestive tract symptoms, and the degree of adverse reactions are severe in no chronic disease group patients.