304例医学影像对比剂不良反应事件原因分析及对策

Analysis and countermeasures of adverse reactions/events caused by medical imaging contrast media:a report of 304 cases

目的分析某院医学影像对比剂(造影剂)引发的药品不良反应(ADR)发生的特点、规律及相关危险因素,为减少临床用药风险提供参考。方法收集医学影像对比剂引发的不良反应/事件病例,按患者年龄、性别、ADR累及器官/系统及临床表现、关联性评价及报告类型、发生时间、转归情况等进行统计分析。结果影像对比剂发生不良反应304例,涉及5个品种,均为非离子型碘对比剂。药品不良反应累及多个器官及系统,不良反应症状表现依次为皮肤及其附件损害、胃肠系统损害、全身性损害、中枢及外周神经系统损害、心血管系统损害、呼吸系统损害、交感副交感神经系统损害。不良反应程度(ADR)新的一般10例,严重9例。结论非离子型碘对比剂所致不良反应以急性、轻中度为主,严重不良反应发生迅速,表现为全身性损害,医务人员应迅速评估患者的状况和不良反应严重程度,同时采取不同的处置和治疗措施。

Objective To analyze characteristics,rules and related risk factors of adverse drug reactions(ADR)induced by medical imaging contrast media,and to provide reference for reducing the risk of clinical medication.Methods Adverse reactions/events caused by image contrast agents were collected and analyzed statistically according to age,gender,organs/systems affected by ADR,clinical manifestations,relevant evaluation and report type,appearance time,and outcome of patients.Results There were 304 cases of ADR caused by nonionic iodine contrast medium involved five types during the investigation.Multiple organs and systems were affected by ADR,and frequency of major toxicity reaction were skin and its accessories damage,gastrointestinal system damage,systemic damage,central and peripheral nervous system damage,cardiovascular system damage,respiratory system damage,sympathetic and parasympathetic nervous system damage,successively.There were 10 cases showed new and mild adverse reactions otherwise 9 cases severe.Conclusion The main adverse reactions caused by nonionic iodine contrast agent are acute,mild to moderate.Serious adverse reactions occur rapidly,presenting as systemic damage.Status of patients and the severity of the adverse reactions should quickly be assessed by medical staff while different therapeutic measures will be taken by them.