3种静脉通路在肿瘤患者CT增强扫描对比剂高压注射中的应用比较

Application effect comparison of three venous accesses in high pressure injection of CT enhanced scan contrast media for cancer patients

目的比较不同静脉通路用于CT增强扫描对比剂高压静脉注射的效果,为肿瘤患者选择合适的静脉通路提供实证依据。方法将200例CT增强扫描肿瘤患者,按不同的对比剂高压静脉注射通路分为三组,分别为22G(巴德)留置针(留置针组,88例),耐高压注射针头输液港(输液港组,55例),耐高压PICC导管(PICC组,57例)。均采用高压注射泵输注碘佛醇注射液(1.5 mL/kg),调整最大压力不超过324 psi,流速1.6~2.5 mL/s。记录并比较三组对比剂注射流速、静脉通路压力、对比剂注射时间,以及患者注射部位的胀痛感和图像扫描质量。结果三组对比剂注射流速、静脉通路压力和对比剂注射时间,以及注射时胀痛程度和图像扫描质量比较,差异有统计学意义(均P<0.05);其中留置针组流速最高[(2.30±0.16)mL/s],压力最低[(48.58±3.15)psi],注射时间最短[(35.12±4.88)s],患者的胀痛感最轻(秩均值70.50),图像扫描质量最优(秩均值73.51)。结论在CT增强定位高压静脉注射对比剂时,采用22G留置针效果优于耐高压PICC和输液港。

Objective To compare the application effects of different venous accesses in high pressure injection of CT enhanced scan contrast media,so as to provide evidence for selecting appropriate venous access for cancer patients.Methods A total of 200 cancer patients undergoing CT enhanced scan were divided into three groups according to different venous accesses used for high pressure injection of contrast media,which were 22G(Bard)indwelling needle(indwelling needle group,n=88),the high-pressure resis-tant injection needle infusion port(infusion port group,n=55),and the high-pressure resistant injection PICC catheter(PICC group,n=57).All the participants were injected loversol injection by using high pressure injection pump,with the maximum pressure was no more than 324 psi,and the flow rate was 1.6-2.5 mL/s.The injection flow rate,the venous access pressure,the length of contrast media injection period,the pain at the injection site and the quality of image scanning were recorded and compared among the three groups.Results There were significant differences in the injection flow rate,the venous access pressure,the length of contrast media injection period,the pain at the injection site and the quality of image scanning among the three groups(all P<0.05).In the indwelling needle group,the injection flow rate was the highest[(2.30±0.16)mL/s],the pressure was the lowest[(48.58±3.15)psi],the length of injection period was the shortest[(35.12±4.88)s],while the pain at the injection site was the mildest(rank mean 70.50),and its quality of image scanning was the best(rank mean 73.51).Conclusion In CT enhanced positioning of high-pressure intravenous injection of contrast media,the application effect of 22G indwelling needle is better than using PICC and infusion port.