20418例CT检查非离子型碘对比剂不良反应分析

Adverse Reactions Induced by Non-ionic Iodinated Contrast Agent in 20,418 Patients receiving CT Examination

目的分析CT检查注射非离子型碘对比剂用药信息与不良反应发生特点,为临床CT检查选择用药、患者告知、针对性各类不良反应处置提供实证依据和参考借鉴。资料与方法回顾性分析2013年7月—2016年9月甘肃省人民医院放射科20 418例行CT检查应用非离子型碘对比剂病例的一般资料、用药类型与名称、不良反应发生时间与症状表现等。结果本组观察对象中,男11 679例、女8739例,年龄3~93岁,平均(52.1±13.2)岁。非离子型碘对比剂各类不良反应发生率为0.4%,次高渗、等渗碘对比剂不良反应发生率分别为0.47%、0.27%。81例不良反应中,急性91.3%,其中88.9%发生在注射后15 min内;迟发性8.7%。轻中度97.6%,重度2.4%。引起不良反应的碘对比剂次高渗74.0%,等渗26.0%;迟发不良反应主要为等渗对比剂所致,表现为轻中度。不良反应症状表现频次依次为皮肤、消化道、中枢神经系统、呼吸系统、循环系统症状。结论碘对比剂所致不良反应以急性、轻中度为主,检查前应向患者或家属详尽告知。碘对比剂重度不良反应发生迅速,多系统同时受累,现场有效处置极为关键;等渗碘对比剂所致迟发反应需引起重视。

Purpose Medicine information and features of adverse reactions induced by non-ionic iodinated contrast agent injection for CT examination are analyzed and discussed, offering empirical evidence and reference for medication choice and patient information for clinical CT examination and targeted adverse reactions disposal. Materials and Methods General material, medicine type and name, adverse reactions occurrence time, symptoms and other information of the 20,418 patients receiving CT examination with non-ionic iodinated contrast agent at X-ray Department in Gansu Provincial Hospital from July 2013 to September 2016 were retrospectively analyzed. Results For observation objects in this group, 11,679 were male and 8,739 female, aging from 3 to 93 and the average age was（52.1±13.2） years. Various adverse reactions occurrence rate of non-ionic iodinated contrast agent was 0.4% and adverse reactions occurrence rate of secondary hypertonic contrast and isotonic contrast agent was 0.47% and 0.27%, respectively. Among the 81 adverse reactions, 91.3% were acute, among which 88.9% occurred within 15 min after injection. 8.7% were delayed, 97.6% mild and moderate, and 2.4% severe. Secondary hypertonic contrast and isotonic contrast agent occupied 74.0% and 26.0%, respectively for the cause of adverse reactions. Delayed adverse reactions were mainly caused by isotonic contrast agent, representing as mild and moderate. Representation frequency of adverse reactions symptoms in turn was skin, digestive tract, central nervous system, respiratory system and circulatory system. Conclusion Adverse reactions caused by iodinated contrast agent were mainly acute and mild and moderate. The patients or their family members shall be fully notified before examinations. Severe adverse reactions caused by iodinated contrast agent developed very quickly and multi-systems would be damaged. Efficient on-site treatment is very important. Delayed reactions caused by isotonic contrast agent shall be paid more attention.