泛影葡胺和碘海醇、优维显在螺旋CT增强扫描中的对比研究

目的　评价 60 %泛影葡胺、碘海醇和优维显 3 0 0临床应用的安全性 ,以最好的效能价格比选择对比剂。方法　分别观察 60 %泛影葡胺、碘海醇及优维显 3 0 0于螺旋CT增强扫描 10 6例、12 0例和 2 3 0例 ,比较其不良反应和图像质量。结果　 60 %泛影葡胺、碘海醇与优维显 3 0 0轻、中度不良反应发生率分别为 5 .7%、1.7%和 2 .6%。三种对比剂均未发生严重不良反应。应用三种对比剂所获图像质量均达到诊断要求。结论　 60 %泛影葡胺应用于非高危人群是相对安全的     

CT增强扫描中碘对比剂过敏反应及防治体会

300例使用增强CT对比剂患者分为两组:一组100例使用离子型对比剂泛影葡胺;二组200例使用非离子型对比剂碘海醇,观察患者的过敏反应。结果使用离子型对比剂中有12例发生过敏反应(占12%),其中1例出现中重度反应;使用非离子型对比剂中5例出现轻度反应(占2.5%)。在使用碘对比剂的CT增强扫描中尽量使用非离子型对比剂,特别高危因素的患者,避免或减轻过敏反应的发生。     

离子型、非离子型对比剂用于CT增强的效果分析

CT增强的对比剂为经肾脏排泄的水溶性对比剂，按分子结构分为离子型对比剂、非离子型对比剂两大类。我院使用的离子型对比剂为泛影葡胺、非离子型对比剂为碘海醇，现将这两种对比剂的使用效果加以分析介绍。     

国产离子型对比剂在CT增强扫描中的应用

目的：评价国产离子型对比剂的临床安全性,并与进口非离子型对比剂进行比较。方法：1096例CT增强扫描中,864例使用76%复方泛影葡胺,232例使用优维显,对比其不良反应和影像质量。前者又随机分组,273例CT增强前静脉注射地塞米松,591例未用地塞米松,观察预防用药的作用。结果：76%复方泛影葡胺总的和轻中度不良反应的发生率高于优维显,重度和死亡不良反应的发生率与优维显近似,影像质量好于优维显。预防用药可减轻各种程度的不良反应。结论：对无高危因素的患者,预防用药后,国产离子型对比剂可安全有效地应用于CT诊断。     

国产离子型对比剂在胃癌螺旋CT诊断中的应用

我科对 15 5例胃癌进行了螺旋ＣＴ增强扫描 ,积累了丰富的对比剂使用资料。现对国产 6 0 %泛影葡胺在螺旋ＣＴ增强扫描中的应用总结如下 :1　材料与方法经手术病理证实的胃癌患者 2 13例 ,男 134例 ,女 79例。年龄 32～ 76岁 ,平均 6 1岁。 15 5例使用国产离子型对比剂 ,5 8例使用非离子型对比剂 ,离子型对比剂选用中国无锡生产的 6 0 %泛影葡胺 ,规格 10 0ｍｌ,含量 2 92ｍｇＩ/ｍｌ,消毒无菌性水溶液 ,透明无色 ,在 37℃时渗透压15 0 0ｍｍｏｌ。非离子型对比剂选用德国先灵公司生产的优维显 ,规格 10 0ｍｌ,含量30 0ｍｇＩ/ｍｌ,消毒无菌…     

非离子型对比剂在静脉注射碘过敏试验中的效果观察

目的:探讨非离子型对比剂在碘过敏试验中的效果。提高碘对比剂的安全性,减少不良或过敏反应的发生,提高护理质量。方法:选取我院自2009年8月～2010年8月做碘过敏试验的患者400例,其中200例给予静脉注射离子型对比剂泛影葡胺(泛影葡胺组),200例给予静脉注射非离子型对比剂优维显(优维显组),分析两者的不良反应,并对400例患者进行全程观察与护理,总结与分析存在的护理问题。结果:400例出现不良反应19例,其中优维显组5例,不良反应率为2.5%,泛影葡胺组14例,不良反应率为7.0%,两组相比具有显著性差异(P<0.05)。结论:非离子型对比剂是安全有效的,值得在临床上应用和推广,但在临床上仍会出现问题,仍需加强观察与防范,消除隐患。     

CT增强扫描120例护理体会

我院CT增强扫描现为临床常用诊治方法,现回顾分析120例CT增强扫描资料,总结其应用方法及护理,报告如下。1资料与方法1.1临床资料本组120例,男66例,女54例,5～80岁,平均51.2岁。其中50例使用离子对比剂(60%泛影葡胺),70例使用非离子型对比剂(欧苏碘海醇或双北碘海醇)。1.2方法CT增强采用静脉注射法,静脉穿刺时,选择粗、直、富有弹性的血管,穿刺点以靠近心脏为好。穿刺后首先用30%泛影葡胺静脉推注1ml做过敏试验。15～20min后观察患者有无过敏反应,无副反应者,经肘静脉缓慢静脉注射地塞米松10mg,5～10min后再连接高压注射器,先推注5ml对比…     

离子型与非离子型对比剂在排泄性尿路造影中的效果评价

【目的】探讨离子型与非离子型对比剂在排泄性尿路造影中的应用效果。【方法】根据排泄性尿路造影受检者所使用对比剂的不同,将569例受检者分为离子型组和非离子型组。离子型组使用76％复方泛影葡胺作对比剂,共224例;非离子型组使用碘海醇（300mgI／mL）作对比剂,共345例,观察两组病例不良反应发生情况、肾脏显影强度及显影时间。【结果】非离子型对比剂不良反应的发生较离子型对比剂低,差异显著（χ^2=30．359,P〈0．01）;且肾脏显影强度及显影时间优于离子型组（P〈0．05）。【结论】非离子型对比剂在排泄性尿路造影中使用能大大增加造影检壹的安全性和患者的舒适感,提高影像质量和检查效率。     

静脉肾盂造影碘对比剂不良反应的护理体会

静脉肾盂造影（intravenous pyelography，IVP）亦称静脉尿路造影，是将有机碘水溶性对比剂注入静脉、对比剂在泌尿系统排泄过程中进行X线摄片检查的方法。碘剂在使用过程中可能发生不良反应，国内文献报道离子型碘对比剂（76％泛影葡胺）不良反应发生率为6．97％，非离子型（欧乃派克、碘海醇等）为3．5％。本文对本科563例IVP中26例不良反应的护理作一小结。     

不同密度口服阳性对比剂对PET/CT图像质量及标准摄取值的影响

目的探讨不同密度口服阳性对比剂对PET/CT图像质量和标准摄取值(SUV)的影响。方法60例PET/CT显像患者,显像前常规口服浓度为2%的泛影葡胺1000ml,其中14例患者肠道内发现多处高密度残留钡剂。所有患者均同时采用CT及137Cs两种衰减校正方法,分别重建CT衰减校正(CTAC)、137Cs衰减校正(CsAC)图像。选择所有患者胃肠道内泛影葡胺充盈区、无对比剂充盈区、臀部软组织区以及14例患者高密度钡剂充盈区勾划感兴趣区(ROI)。比较各感兴趣区CTAC和CsAC的平均SUV差异,以及CTAC、CsAC的图像差异。结果在所有正常软组织区、无对比剂充盈区以及泛影葡胺充盈区,CTAC和CsAC的平均SUV无显著性差异。在高密度残留钡剂充盈区,CTAC的平均SUV明显高于CsAC(t=3.451,P=0.018),其差异与CT值成正相关(r=0.445,P=0.021)。比较所有图像,正常软组织、无对比剂充盈区、泛影葡胺充盈区CTAC和CsAC图像质量无明显差异。在高密度残留钡剂充盈区,CTAC图像上可见FDG高摄取伪影,而CsAC图像为正常摄取。结论低密度口服泛影葡胺对PET/CT显像图像质量和标准摄取值无明显影响,高密度钡剂可使PET/CT的SUV明显高估,且可出现不同程度的FDG高摄取伪影。     

强直性脊柱炎96例心理健康状况调查与心理干预

目的：探讨强直性脊柱炎患者的心理健康状况及心理干预的效果。方法：采用焦虑自评量表（SAS）和抑郁自评量表（SDS）对96例强直性脊柱炎患者进行心理问卷调查，根据患者存在的焦虑、抑郁心理问题实施心理干预2周，再次进行SAS和SDS自评量表评分。结果：本组心理干预前SAS、SDS评分较国内常模高，两组比较有极显著性差异（P〈0．01）；干预后患者SAS、SDS评分较干预前低，两组比较有极显著性差异（P〈0．01）。结论：强直性脊柱炎患者存在明显的焦虑、抑郁心理，实施心理干预后患者焦虑、抑郁心理有明显改善。     

The ionic contrast medium ioxaglate interferes with thrombin-mediated feedback activation of factor V, factor VIII and platelets

Summary.  Clinical observation shows that radiographic contrast media (CM) may influence thrombus formation. In the search for the underlying mechanism, we have shown that the ionic CM ioxaglate is a potent inhibitor of thrombin generation in platelet-poor and platelet-rich plasma, whereas the influence of the non-ionic contrast medium iodixanol is minimal. Ioxaglate boosts the inhibitory effect of the platelet GPIIb/IIIa antagonist abciximab and the effects of ioxaglate and heparin are additive. Ioxaglate inhibits the clotting of fibrinogen and the activation of factors V and VIII, and of platelets by thrombin. It does not inhibit hydrolysis of small chromogenic thrombin substrates, nor does it influence the heparin-catalyzed inactivation of thrombin by antithrombin. We assume therefore that ioxaglate interferes with the binding of macromolecular substrates to the anionic exosite I of thrombin. The biological correlation to the observed antithrombotic effect of ioxaglate is then to be found in the inhibition of thrombin generation via inhibition of thrombin-mediated feedback activations.     

Prolonged contrast of kidney tumors using an oily x-ray contrast medium

In 194 patients with tumourous kidney disease an angiographic investigation with the oily x-ray contrast medium Iodolipol was carried out. A selective tropism of oily-x-ray contrast media was found that was only retained in zones of malignant disease. The application of the preparation caused no complications. The oily x-ray contrast medium persisted in the tumours over several weeks or months. After embolization of the renal artery a moderate size reduction of malignant tumours in the first 10-14 d was seen. The ability of Iodolipol for a lasting retainment in malignant tumour tissue allows a follow-up of the involution of the pathologic focus after arterial embolization of the tumour vessels.     

Stable paclitaxel formulations in oily contrast medium.

Stable paclitaxel/Lipiodol solutions as well as emulsions were developed for the treatment of solid tumors including hepatocellular carcinoma. Paclitaxel could be dissolved in Lipiodol, an oily contrast medium, but precipitated out and formed aggregates with time. Paclitaxel precipitation was due to the inter- and intra-molecular hydrogen bonding of paclitaxel molecules. Time-dependent paclitaxel aggregation was completely prevented by adding small amounts of additional solvents, which are miscible with Lipiodol. It was also notable that paclitaxel helped in stabilizing the water-in-oil (w/o) type emulsion of Lipiodol and Iopamiro. The stability, physical properties and in vitro drug release profiles of the stable paclitaxel solutions and emulsions were characterized. When the stable oily paclitaxel solution was used for the treatment of B16F10 melanoma in C57BL/6 mice, the malignant cells were eradicated completely in 2 weeks, whereas the solid tumor grew rapidly and metastasized to the thigh and to other organs in the control group. Also, the mice survived for more than 1 year after the paclitaxel treatment, whereas all of those in the control group died in 40 days.     

Niobium powder--a new x-ray contrast medium for tracheobronchography

In inhalation tracheobronchography with niobium powder in rabbits and a volunteer (physician), excellent contour bronchograms with detailed imaging of the structure of the mucosa were obtained. With methodically proper application the niobium particles of 20-40 microns do not penetrate into the alveoli and are quickly (within 1-5 days) eliminated from the bronchi. Investigations with mice have shown, that niobium powder is insoluble, does not irritate tissues and is not resorbed. It is also nontoxic.     

Pilot study on basophil activation induced by contrast medium

The purpose was to analyze the influence of both mono‐/dimeric X‐ray contrast media (CM) and immunological co‐factors on basophil degranulation. The study has been conducted in 31 adult patients who received nonionic CM injection for enhanced routine computed tomography examination. Plasma histamine, and basophil degranulation by using CD63 expression and flow‐cytometry in blood samples of patients receiving iotrolan or iopromide injections were analyzed in vivo and in vitro (with different stimuli) before and up to 24 h after CM‐injection. After iotrolan injection, histamine values remained unchanged and showed minimal increase after iopromide. In 5/12 patients receiving iopromide and in 5/19 in the iotrolan group histamine level rose (>100% of the baseline). After CM‐injection, a significant activation of basophils (CD63) could be measured (P < 0.05). IL‐3 prestimulus revealed a more pronounced CD63 expression after iopromide than after iotrolan. The IL‐1β prestimulus seemed to be dose‐dependent. Patients showing the most marked CM‐induced CD63 expression had the highest predose values after in vitro N‐formyl‐methionyl‐leucyl‐phenylalanine treatment. Our finding suggests that increased histamine values and CD63 expression on basophils could depend on individual stimuli. Iopromide and iotrolan per se neither enhanced histamine release nor basophil degranulation under normal conditions. Analysis of CD63 expression by using fluorescence activated cell sorter‐analysis is an interesting new tool to elucidate the complex conditions leading to CM‐mediated hypersensitivity reactions.