CT增强扫描时大量造影剂外溢原因分析及防治措施

Cause analysis of large amount of contrast media extravasation at CT enhanced scanning and prevention measures

目的探讨CT增强扫描时大量造影剂外溢的原因及防治措施。方法选取2013年7月～2015年11月于首都医科大学附属北京世纪坛医院行CT增强扫描的患者2500例,观察扫描时是否出现大量造影剂外溢情况,针对造影剂外溢原因进行单因素描述分析和多因素Logistic回归分析,并探讨预防措施。结果 2500例患者经CT增强扫描,其中21例(0.84%)存在大量造影剂外溢情况。单因素分析发现年龄、疾病类型、注射血管部位、注射流速、渗透压、患者依从性及护士操作技术不熟练等与大量造影剂外溢有关(P <0.05)。多因素Logistic回归分析显示,年龄(OR=1.825)、疾病类型(OR=2.054)、注射流速(OR=3.024)、渗透压(OR=2.687)、依从性(OR=1.953)及护士操作技术(OR=2.547)为大量造影剂外溢的独立危险因素。结论 CT扫描时大量造影剂外溢影响因素存在相互作用,应针对相关因素加强护理干预并提升穿刺技巧,提高增强扫描安全性。

Objective To explore the causes and preventive measures of a large number of contrast agent overflowing in CT enhanced scanning.Methods A total of 2500 patients with CT enhanced scan in Beijing Shijitan Hospital,Capital Medical University from July 2013 to November 2015 were selected to observe whether a large number of contrast agent spillovers appeared during the scan.Through single factor description analysis and multivariate Logistic regression analysis,the causes of contrast agent overflow were analyzed,and preventive measures were discussed.Results A large number of contrast agent overflows were found in 21(0.84%)of 2500 patients after CT enhanced scan.Single factor analysis showed that in the age,disease typ,injection vessel site,injection velocity,osmotic pressure,poor compliance of patients and nurses are not skilled were related to a large number of contrast agent overflowing(P<0.05).Multivariate Logistic regression analysis showed that age(OR=1.825),disease type(OR=2.054),injection velocity(OR=3.024)and osmotic pressure(OR=2.687),Compliance(OR=1.953)and skill level of nurses(OR=2.547)were independent risk factors affecting the extravasation of a large number of contrast agents.Conclusion The influence factors of a large number of contrast agent spillovers in CT scan are interacted.Strengthening nursing intervention according to the related factors,improve the skill of puncture,improve the security of enhanced scan.