多发伤螺旋CT增强检查中对比剂应用及安全管理_临床医学论文.docVIP

多发伤螺旋CT增强检查中对比剂应用及安全管理_临床医学论文 多发伤螺旋CT增强检查中对比剂应用及安全管理_临床医学论文 作者：李雪，张伟国，陈蓉，冉启胜，陈金华 【摘要】 目的 探讨多发伤螺旋CT增强检查中碘对比剂应用及安全性管理。方法 回顾性分析2009年1月～2010年3月行螺旋CT增强检查的134例多发伤患者，男性106例，女性28例;年龄2～82岁，平均42.5岁。道路交通伤55例，刀刺伤15例，坠落伤39例，砸伤25例。对比剂主要采用欧乃派克(350mgI/ml)、优维显(370mgI/ml)、三代显(350mgI/ml )，用量1.5～2ml/kg，注入速度3.0～4.0ml/s。制定多发伤CT增强检查流程，观察检查过程中生命体征及其他不良反应。结果 螺旋CT增强扫描新发现血管等损伤59例次;5例注射对比剂时心率、呼吸加快，但血压稳定，129例无明显生命体征改变;未见恶心、呕吐、皮疹等不良反应症状。2例因躁动配合困难，镇静后行螺旋CT增强检查，导致检查时间延长之外，132例在8～10分钟之内顺利完成检查。结论 多发伤螺旋CT增强检查有助于发现血管及实质性脏器损伤，以上3种对比剂安全、有效。 【关键词】 多发伤;螺旋CT;碘对比剂 　　【Abstract】 Objective To investigate the security management of contrast agent in spiral CT enhancement of multiple injuries.Methods Totally 134 cases of multiple injuries who had spiral CT enhancement scanning during Jan.2009 to Mar.2010 were retrospectively analyzed.There were 106 males and 28 females, aging from 2 to 82 years (mean age 42.5).The injury causes included 55 cases of road traffic injuries,15 cases of knife stabbing,39 cases of fall injury,and 25 cases of crushing.The applied contrast agents were as follows,such as Omnipaque(350mgI/ml),Ultravist(370mgI/ml),Xenetix(350mgI/ml),with volume of use 1.52ml/kg,and injection rate 3.04.0ml/s.The examination process was formulated and vital signs and other adverse reactions were observed during examination.Results Totally 59 cases of vascular injury were observed by enhanced spiral CT scan;5 cases were found acceleration of heart rate and breathing,but the blood pressure was stable at the time of injection,no significant changes in vital signs were observed in 129 cases;there was no nausea,vomiting,skin rashes and other symptoms of adverse reactions.Totally 132 patients were completed the enhancement scanning smoothly in 810 minutes except for 2 cases who used sedatives had longtime examination because of restlessness.Conclusion Spiral CT enhancement of multiple injuries is helpful to detect injuries of vessels and substantial organs,and the above three kinds of contrast agents are safe