美国磁共振设备使用报告中患者安全事件分析及启示

Analysis and Enlightenment of Patient Safety Events in the Use Report of Magnetic Resonance Equipment in the United States

目的分析美国磁共振设备使用报告中患者安全事件相关数据,为降低此类事件发生率提出建议。方法检索美国FDA MAUDE数据库,获取2017年1月1日-2021年12月31日报告的磁共振设备相关安全事件,应用Excel表格进行分类分析。结果纳入的388份患者安全事件报告中,灼伤是最常见的伤害类型(56.44%),其次分别为听觉伤害(16.49%),机械性损伤(14.18%),抛射(10.82%)图像错误(1.55%),外周神经刺激(0.26%)及窒息(0.26%)。结论磁共振设备使用安全不容忽视。建议做好患者检查时的肢体隔离措施,重视对患者听力保护,加强对患者随身金属物品检测,关注患者体位摆放,特别避免患者乳腺扫描时肋骨骨折,以确保患者磁共振检查安全。

Objective To analyze the related data of patient safety events in Magnetic Resonance Imaging(MRI)equipment in USA,and provide suggestions for reducing the probability of such events in clinical practice.Methods The FDA MAUDE database was searched to obtain the safety incidents related to MRI equipment reported from January 1,2017 to December 31,2021,and the Excel table was used for clasification analysis.Results Among the 388 patient safety events,burn was the most common injury type(56.44%),followed by hearing injury(16.49%),mechanical injury(14.18%).object ejection(10.82%).image problem(1.55%),peripheral nerve stimulation(0.26%)and asphyxia(0.26%).Conclusion The safety use of MR1 equipment cannot be ignored.It was suggested to do a good job of physical isolation measures during the examination of patients,pay attention to the hearing protection of patients,strengthen the detection of metal objects on patients,pay attention to the posture positioning of patients,especially to avoid the rib fracture during breast scan,so as to ensure the safety of MRI examination for patients.