CT增强扫描碘造影剂不良反应分析

目的分析CT增强扫描中碘造影剂发生不良反应的特点,为临床用药提供参考。方法回顾性分析该院2017年1月至2018年5月CT室进行增强扫描发生碘造影剂不良反应病例资料,分别按照患者性别、年龄、碘造影剂种类、不良反应发生时间、累及系统、临床表现等进行统计分析。结果在2500例CT增强扫描患者中,81例发生碘造影剂不良反应,发生率为3.24%,其中男性患者35例,女性患者46例,男女比例为0.76:1;涉及药品包括碘普罗胺、碘海醇、碘克沙醇、碘佛醇等常用的非离子型碘造影剂,以碘普罗胺和碘海醇为多。皮试过程中发生不良反应27例,正常用药后发生不良反应54例。过敏反应临床表现多样,以皮疹、瘙痒等皮肤及其附件损害最为常见,其次为恶心、呕吐等胃肠道损害;过敏性休克最为严重,无死亡病例。结论CT增强扫描应用碘造影剂时,用药前应重视不良反应的预防和必要急救准备,用药时密切观察,出现不良反应时早期识别与干预,以提高碘造影剂临床用药安全。

Analysis of Adverse Reactions Induced by Iodine Contrast Media in CT Enhanced Scan

Objective To analyze the characteristics of adverse reactions of iodine contrast media in CTenhanced scanning,so as to provide reference for clinical medication.Methods A retrospective analysis was performed on the data of patients with adverse reactions of iodine contrast media used in the CT Room of our hospital between January 2017 and May 2018.The gender,age,types of iodine contrast media,time of adverse reactions,systems involved and clinical manifestations of the patients were statistically analyzed.Results Among the 2500 patients who received iodine contrast media during CTenhanced scanning,81(3.24%)ended up with adverse reactions,of whom 35 were males and 46 were females.The ratio of males to females was 0.76:1.Such commonly used non-ion iodinated agents as iopromide,iohexol,iodixanol and ioversol were involved,and iopromide and iohexol were responsible for most of the cases of adverse reactions.27 cases occurred during the skin test,and 54 cases occurred after intravenous administration.The clinical manifestations of the anaphylactic reactions varied.Skin and its accessories disorders,such as rashes and pruritus,were the most common,followed by gastrointestinal disorders such as nausea and vomiting.Anaphylactic shock was the most serious but no death occurred.Conclusion Before using the media,we should pay attention to the prevention of adverse reactions and be prepared for any emergency,observe closely,identify adverse reactions and intervene early so as to improve the safety of clinical use of iodine contrast media.