生理盐水清除导管间隙降低高压注射对比剂静脉空气栓塞发生率的效果研究

Study on the Effect of Normal Saline Clearing Catheter Gap to Reduce the Incidence of Venous Air Embolism in Power Injection of Contrast Media

目的探讨用生理盐水清除高压注射器延长管和留置针导管间隙对高压注射对比剂静脉空气栓塞(VAE)发生率和发生情况的影响。方法纳入2021年6月至10月在我院放射科接受冠状动脉CT血管成像(CCTA)检查的169例门诊患者,随机分为干预组88例和对照组81例。干预组用生理盐水清除高压注射器延长管和留置针导管的间隙后连接,对照组用常规连接方法。由2位经验丰富的诊断医师在检查结束后,对重建后的CT图像中出现的气泡或者气-液平面进行评估,比较两组患者VAE发生率及发生情况。结果两组患者的性别、年龄、体质量、检查时心率、静脉留置针的部位、对比剂总量比较,差异无统计学意义(P>0.05);干预组和对照组VAE发生率分别为4.55%、14.81%,差异有统计学意义(P<0.05);两组VAE程度比较,差异无统计学意义(P>0.05);对照组检出37个空气栓子,干预组检出5个空气栓子,两组空气栓子的数量比较差异有统计学意义(P<0.05),两组空气栓子的直径、位置比较,差异无统计学意义(P>0.05)。结论用生理盐水清除高压注射器延长管和留置针导管的间隙减少了进入患者体内的空气体积,降低了VAE发生率,有利于提高高压注射对比剂的安全性。

Objective To investigate the effect of using normal saline to clear the gap between the pressure extension tube and indwelling needle catheter on the incidence and occurrence of venous air embolism(VAE)induced by power injection of contrast media.Methods A total of 169 outpatients who underwent coronary computed tomography angiography(CCTA)examination in the Radiology Department of our hospital from June to October 2021 were included.They were randomly divided into an interventional group and a control group.The intervention group(n=88)employed normal saline to clear the gap between the pressure extension tube and indwelling needle catheter before connecting,while the control group(n=81)chose the conventional connecting method.Two experienced diagnosticians evaluated the bubbles or gas-liquid levels in the reconstructed CT images after the CCTA examination.The difference in the incidence and degree of VAE between the two groups was compared.Results There was no significant difference in gender,age,weight,heart rate during examination,location of intravenous indwelling needle,and total amount of contrast media between the two groups(P>0.05).The incidence of VAE in the intervention group(4.55%)was lower than that in the control group(14.81%),the difference was statistically significant(P<0.05).There was no significant difference in the degree of VAE between the two groups(P>0.05).The control group detected 37 air embolus while the intevention group detected 5 air embolus.The difference in the number of air embolus was statistically significant(P<0.05),while there was no significant difference in the diameter and location of air embolus between the two groups(P>0.05).Conclusion Clearance of the gap between the pressure extension tube and the indwelling needle catheter with normal saline decreases the volume of air entering the patient's body,reduces the incidence of VAE,thus improving the safety of power injection of contrast media.