磁共振检查安全隐患与防护对策探讨

Discussion on safety hidden danger and protection countermeasure of magnetic resonance examination

目的:介绍MR检查中存在的安全隐患、禁忌症、注意事项以及紧急情况下的防护对策.方法:通过认真分析2019年1月份至3月份在我院行MR检查的13495例患者的临床资料、检查申请单、检查部位等资料,总结MR检查过程中存在的问题及注意事项.结果:13495例中13413例患者顺利完成检查,7例患者因幽闭恐惧综合征坚决拒绝检查,23例因体内有动脉夹或钢板植入物及时发现而阻止检查,35例因自主呼吸差,无法配合腹部扫描规定的屏气时间,图像质量差,中途停止检查,13例因神志不清、易躁动,无法配合而放弃检查,1例因发烧而未行检查,3例因肾功能不全未行增强扫描而影响诊断.其中5例陪同的临床实习医师1例将止血钳带进磁体间并吸入磁体,4例因笔帽上的金属将笔吸进磁体,另有6位老年患者将硬币带进磁体间并吸入磁体,幸而未造成人员及机器损伤、损坏.结论:磁共振检查中存在各种各样的安全隐患,我们必须有高度的责任心、警惕心,认真细致的沟通交流,以及全面优质的护理,才能将安全隐患消灭在萌芽状态,确保医院的医疗工作顺利进行.

Purpose:Introduce the safety hazards,contraindications,precautions,and protective measures in emergency situations of MR examination.Methods:By carefully analyzing the clinical data,examination application forms and examination sites of 13495 patients who underwent MR examination in our hospital from January to March 2019,the problems and matters needing attention in the process of MR examination were summarized.Results:Among 13495 cases,13413 patients successfully completed the examination,7 patients refused the examination because of claustrophobia syndrome,23 patients were prevented from examining because of the timely discovery of arterial clips or plate implants in vivo,35 patients were unable to cooperate with the breath-holding time prescribed by abdominal scan due to poor spontaneous breathing,poor image quality,and stopped examining halfway,13 patients were unable to cooperate and abandoned examinations because of unconsciousness and agitation.One case did not undergo examination because of fever,and three cases did not undergo enhanced scanning because of renal insufficiency.Among them,one of the accompanying clinical interns took the hemostatic forceps into the magnet and inhaled the magnet.Four interns inhaled the pen into the magnet because of the metal on the pen cap.Another six elderly patients took the coin into the magnet and inhaled the magnet.Fortunately,no injury or damage was caused to the personnel or the machine.Conclusion:There are all kinds of potential safety hazards in magnetic resonance examination.We must have a high sense of responsibility,vigilance,careful communication,and comprehensive and high-quality care,in order to eliminate the potential safety hazards in the bud and ensure the smooth progress of hospital medical work.