CT检查中造影剂不良反应的预防、处理及对影像学检查的影响分析

Prevention, Treatment of Adverse Reactions Imaging Findings of CT Scan Contrast Agent and the Impact on the Examination

目的:在CT等医学影像检查过程中,常需要应用造影剂。在造影剂的使用常常发生不良反应,掌握不良反应的发生率,减少或减轻患者的不良反应,能够使CT增强扫描顺利进行,提高检查安全性。方法:搜集我院2011年10月至2012年9月间的1500例CT造影增强检查患者,包括冠状动脉CT血管成像(冠脉CTA)、头部CT血管成像(头CTA)、肝脏增强、泌尿系三维成像(CTU)以及双下肢血管成像(双下肢CTA),进行造影剂的不良反应类型、造影剂药物剂量、注射速度等统计分析,总结造成不良反应发生的因素及处理方法。结果:不良反应的类型包括发热、呕吐、荨麻疹、面色潮红、局部疼痛、流泪、血压下降、喉头水肿、休克等。使用非离子型造影剂出现不良反应者85例,占5.67%。其中轻度反应65例,占4.33%;中度反应16例,占1.06%;重度4例,占0.27%。结论:在CT增强扫描过程中,造影剂的用量及注射速度与不良反应的发生有相关性。CT检查过程总应该认真执行操作流程,密切观察病人情况,积极防治,正确处理,将造影剂不良反应降低到最低程度,使患者更加安全。

Objective： CT and the other medical imaging methods often require the application of the contrast agents. The use of contrast agents occurred adverse reactions, so that we should master the incidence of adverse reactions, reduce or mitigate adverse reactions in patients, enhance CT scan carded out smoothly, improve the security of imaging examination. Methods： 1500 cases were collected in our hospital from October 2011 to September 2012 who were detected by CT contrast-enhanced or MRI, including coronary CT angiography （coronary CTA）, head CT angiography （head CTA）, liver enhancement, urinary of three-dimensional imaging （CTU） and lower limbs angiography （the lower limbs CTA）. Results： The contrast agent type of adverse reactions, the dose of the contrast agent injection speed were analyzed, and the factors and treatment that caused adverse reactions were summarized. The types of adverse reactions included fever, vomiting, urticaria, flushing, local pain, tearing, decreased blood pressure, laryngeal edema and shock. 85 patients reflected adverse reactions after detecting by non-ionic contrast agent which was accounting for 5.67%; 65 patients showed mild which was accounting for 4.33%; 16 patients were presented moderate which was accounting for 1.06%; and severe cases was accounting for 0.27 %. Conclusion： In enhanced CT scan, the amount of contrast agent injection speed was related with the incidence of adverse events. The CT examination process should always be to perform the operation process, close observation of the patients＇ condition, to prevent and handle correctly with the contrast agent to minimize the adverse reactions so that patients would be more secure.