酒精性过敏患者眼底荧光血管造影不良反应分析

目的 观察酒精性过敏患者行FFA检查时不良反应情况,为临床安全应用该检查做出评估与参考.方法 回顾性分析我科近4年行FFA检查患者,把酒精性过敏、药物过敏患者及对照组患者在行该检查时出现的不良反应分为轻、中、重度,通过统计学分析三组间的差异.结果 酒精性过敏患者FFA检查发生不良反应率100%,且多为中度反应,其发生率明显高于其他组(P<0.05).药物过敏组及对照组发生不良反应率相似(P>0.05).结论 对于酒精性过敏患者行FFA检查风险较大,临床上针对该类患者检查时宜慎重,应充分与患者及家属说明情况,并做好完善的抢救准备,及时处理不良反应的发生.

Abstract：

Objective To observe the adverse reactions of alcohol allergy patients in fiindus fluorescein angiography examination, to make some assessment and reference about clinical safety. Methods Retrospective analysis was performed on patients with fundus fluorescein angiography for nearly 4 years in our department. Adverse reactions were divided into light, medium and heavy degrees among patients of alcohol allergy sufferers, drug allergy sufferers and the control group. Differences and similarities among the three groups were through statistical analysis. Results Adverse reactions rate up to 100% in alcohol allergy patients,mostly moderate, its incidence was significantly higher than other groups(P <0.05). Drug allergy group and the control group experienced the similar adverse reactions rate(P >0.05). Conclusions It takes greater risk for alcohol allergy patients to examine with fundus fluorescein angiography, we should take seriously and make full explanations, on the other hand, prepare enough for adverse reactions.     

药物过敏史患者250例眼底荧光血管造影不良反应临床分析

目的：观察对药物过敏史眼科患者,行眼底荧光血管造影时静脉注射荧光素钠的不良反应情况.方法：对有药物过敏史250例和同期无药物过敏史250例眼病患者,静脉注射荧光素钠进行眼底荧光血管造影（fundus fluorecein angiography,FFA）,观察有无不良反应及药物反应情况.结果：有药物过敏史250例中25例发生不良反应,其中荧光造影检查中发生药物反应20例,检查后发生过敏反应5例;无药物过敏史250例中有23例发生不良反应,其中荧光造影检查中发生药物反应18例,检查后发生过敏反应5例.两组均无1例发生心脏骤停等危及生命的严重反应.两组过敏反应发生情况无统计学差异（x2=0.165,P＜0.01）.结论：药物过敏史眼科患者并非FFA绝对禁忌症,但应当强调严格观察注射稀释荧光素钠进行的过敏试验,检查室内常规准备各种急救药品和条件,以便预防万一出现的严重过敏反应.     

眼底荧光血管造影不良反应与药物过敏史的关系

目的:分析行眼底血管荧光造影(fundus fluorecein angiography,FFA)静脉注射荧光素钠不良反应的发生率与既往药物过敏史情况之间的关系。方法:观察160例既往有药物过敏史患者及160例既往无药物过敏史患者静脉注射荧光素钠进行FFA时不良反应的发生率,分析不良反应发生率与既往药物过敏史情况的关系。结果:160例有药物过敏史的患者静脉注射荧光素钠后发生不良发应17例(10.6%),160例无药物过敏史的患者静脉注射荧光素钠后发生不良发应15例(9.4%)。不良反应主要为恶心、呕吐、头晕等不适,无心脏骤停、过敏性休克等危及生命的严重反应。统计学分析两组患者之间静脉注射荧光素钠后不良反应发生率的差异无明显统计学意义(χ2=0.165,P>0.05)。结论:FFA静脉注射荧光素钠不良反应的发生率与既往有无药物过敏史没有明显的相关性,药物过敏史患者不是行FFA检查的禁忌证。     

荧光素眼底血管造影中不良反应的预防及处理

1961年Novotny和Alvis[1]开创了荧光素眼底血管造影(FFA)在临床的应用,目前已成为眼科临床常用的辅助性检查,对眼底疾病的诊治具有极为重要的参考价值.然而,在FFA检查过程中不良反应却时有发生.我们回顾分析了一组行FFA检查患者的临床资料,现将结果报道如下.     

荧光素眼底血管造影不良反应的临床观察

荧光素眼底血管造影(FFA)是眼底疾病诊断的最常用检查技术,在临床应用过程中,FFA不良反应常有发生,成为开展FFA检查必须注意的重要事项[1].为了进一步了解FFA不良反应发生规律,探索其防范措施,现将我院近3年半时间范围内接受FFA检查的连续病例中出现不良反应的情况分析报道如下.     

荧光素钠应用于荧光素造影检查眼底血管的安全性及不良反应特点

目的观察荧光素钠应用于荧光素眼底血管造影(FFA)检查的安全性及不良反应特点。方法收集2011年3月至2014年3月在我院行FFA检查289例患者,记录所有患者不良反应发生情况,并分析其与患者性别、年龄进行相关性。结果在289例患者中,15例发生不良反应,占5.20%,均为轻、中度不良反应,无死亡病例,以恶心、呕吐的不良反应居多。男性发生率显著高于女性(P<0.01);40岁以下的发生率较高。结论在眼底血管造影时应用荧光素钠,是相对安全的。不良反应发生率低,均为轻、中度,死亡病例及严重不良反应极少。而不良反应中产生呕吐的原因可能是强烈的迷走神经反应。男性及中青年人发生率明显增加,可能在于男性及中青年人迷走神经兴奋性高,遇到不良刺激后,精神紧张而容易发生一些不良反应。     

80岁及以上高龄患者眼底血管造影分析

对患有眼底疾病的80岁及以上高龄患者,荧光素血管造影(FFA)和吲哚青绿血管造影(ICGA)是重要的诊断方法[1-2].但眼底血管造影为有创性检查,存在一定的不良反应[3].并且高龄患者常并存高血压、心脏病及肾病等全身疾病,其中一些严重全身疾病不符合FFA或ICGA检查的适应证[4,5].近年推广的眼底自身荧光(FAF)、光相干断层扫描(OCT)等无创性光学影像学检查可以代替部分FFA检查[6,7].对高龄患者眼底病所需检查进行分类,缩小FFA检查范围有助于降低其引起的不良反应,但相关研究国内外报道较少.为此,我们回顾分析了一组80岁及以上高龄患者行FFA或ICGA检查的临床资料,现将结果报道如下.     

六味地黄丸联合银杏叶片防治2型糖尿病早期视网膜病变

目的:探讨六味地黄丸联合银杏叶片防治2型糖尿病早期视网膜病变的临床效果.方法:选取2013-01/2015-01于我院内分泌科门诊进行治疗的2型糖尿病患者82例82眼,依据随机数字表法随机分为观察组和对照组,每组41例41眼.对照组给予常规西医治疗,观察组在对照组治疗的基础上给予六味地黄丸联合银杏叶片治疗.评估两组患者糖尿病视网膜病变情况,以及血糖、血压以及糖化血红蛋白指标变化.记录治疗期间以及治疗后两组不良反应的发生情况.结果:本次研究显示:观察组患者糖尿病视网膜病变新增率以及进展率均低于对照组,缓解率高于对照组,组间差异有统计学意义(P<0.05).两组患者血糖、血压以及糖化血红蛋白治疗前后不具有显著差异,组间差异不具有统计学意义(P>0.05).两组患者不良反应发生率差异无统计学意义(P>0.05).结论:六味地黄丸联合银杏叶片可以有效控制2型糖尿病早期视网膜病变新增率、进展率,提高缓解率,药物安全性高,具有进一步临床研究的意义.     

护理干预在荧光素眼底血管造影和吲哚青绿眼底血管造影中的应用

目的探讨使用护理干预的方法在荧光素眼底血管造影（FFA）和吲哚青绿眼底血管造影（ICGA）检查中的应用,以减少药物所产生的不良反应。方法将476例FFA检查患者按入院时间分为对照组1与干预组1各238例;将112例ICGA检查患者按入院时间分为对照组2与干预组2各56例;,对照组按常规行FFA和ICGA检查,干预组在此基础上针对造影所致的胃肠道反应、过敏反应和神经系统反应等进行护理干预。结果干预组胃肠道反应、过敏反应和神经系统反应的发生率显著低于对照组（均P〈0.01）。结论护理干预有助于FFA和ICGA检查患者安全、顺利地完成检查,减少并发症的发生。     

病理性近视脉络膜新生血管膜发生相关因素及其OCT形态学研究

目的 研究病理性近视脉络膜新生血管膜(CNV)光学相干断层扫描(OCT)形态特征及探讨近视屈光度、眼轴长度与CNV形成有无相关性.方法 对自2004年11月至2006年6月门诊及住院的34例(60只眼)近视患者行眼部A超、B超、屈光度检查,FFA、OCT检查有无CNV,记录黄斑区病理性改变.以眼轴及屈光度为标准将病例分为实验组(眼轴≥26mm,屈光度≥-6.0D)和对照组(眼轴<26mm,屈光度<-6.00D),并将结果用相关性检验、卡方检验进行统计学分析.结果 实验组50只眼中39只眼发生CNV,对照组10只眼中1只眼发生CNV.实验组CNV的发生率明显高于对照组.将实验组与对照组的眼轴、屈光状态同CNV的发生进行统计学分析,有显著的统计学意义(P<0.05).实验组50只眼FFA检查36只眼查出CNV,14只眼未见CNV荧光表现;OCT检查39只眼查出典型CNV图像,11只眼未见CNV.对结果进行卡方检验,OCT与FFA对CNV的检出率对比无统计学意义(P>0.05).结论 眼轴越长,屈光度越大发生CNV的机率越高,眼轴的长短、屈光状态同CNV的发生有相关性.OCT同FFA对病理性近视CNV敏感性无明显差异,OCT在眼底存在少量出血、机化瘢痕、色素沉着等情况下OCT能较FFA更明确地发现CNV.OCT对病理性近视CNV有特征性的形态表现,可作为病理性近视脉络膜新生血管膜的有效补充检测手段.     

Temperature effect on nausea during fluorescein angiography.

PURPOSE: Nausea is the most common adverse effect of fluorescein angiography (FA). Warming of fluorescein dye before injection has been reported anecdotally to decrease nausea frequency. We examined the effect of warmed fluorescein dye on the frequency of adverse effects of FA. DESIGN: Prospective, randomized, controlled trial. PARTICIPANTS: Five hundred forty-seven angiograms performed on 394 patients; 273 were in the control group and 274 were in the study group. METHODS: Patients were alternately assigned to FA using dye at room temperature (control group) or dye prewarmed to body temperature (study group). All patients were masked to the dye temperature. After FA, patients were questioned regarding any adverse effects experienced. MAIN OUTCOME MEASURES: Presence or absence of reported nausea associated with FA. RESULTS: Adverse reactions were reported for 39 of the angiograms (7.1%), including 32 procedures for which nausea was reported (5.9%). No significant difference in the frequency of adverse reactions was found between the two groups (P = 0.41). No significant difference in the frequency of nausea was found between the two groups (P = 0.28). The sample sizes used allow an 80% power for detecting a clinically significant difference of 4% adverse effects in one group and 10% in the other group when testing at a significance level of 5%. CONCLUSIONS: Warming of fluorescein dye does not significantly alter the incidence of nausea reported with FA.     

耳穴压豆预防眼底荧光血管造影胃肠反应的效果观察

目的:探讨耳穴压豆疗法预防眼底荧光血管造影(fluorescence fundus angiography,FFA)胃肠反应的效果.方法:选取2019年10月至2020年4月在汕头大学·香港中文大学联合汕头国际眼科中心特殊检查科行眼底荧光素血管造影检查的患者583例,试验组298例,对照组285例.对照组在检查前予常规...     

Allergy skin testing in predicting adverse reactions to fluorescein: a prospective clinical study

Purpose: To evaluate allergy skin testing as a diagnostic tool of adverse reactions to fluorescein and whether allergy and previous sodium fluorescein angiography (SFA) act as predisposing factors. Methods: Patients with adequate indication for fluorescein angiography and normal skin responsiveness were subjected to allergy skin‐prick and intradermal tests for fluorescein, followed by SFA. During SFA, adverse reactions were monitored and classified as mild, moderate or severe. Previous SFAs and adverse reactions as well as the presence of atopy were also registered. Results: One thousand and thirty‐seven patients were enrolled in the study and 1284 SFAs were executed. Forty‐four patients (4.3%) developed 55 adverse reactions; among them 50 (3.8%) were mild, three (0.2%) moderate and two (0.16%) severe. None of the reactors produced positive skin tests to fluorescein. Patients with atopy and previous SFAs were not more susceptible to adverse reactions. Conclusion: The vast majority of adverse reactions to fluorescein are mild and not attributed to immunological mechanisms. Allergy skin tests cannot predict non‐immunological reactions but their utility remains substantial in predicting anaphylaxis during SFAs and must be performed in patients reporting risk factors in their past medical history.     

Adverse reactions to fluorescein angiography: A comprehensive review of the literature

We reviewed literature on adverse reactions to intravenous fluorescein angiography using PubMed and found 78 articles in English from 1961 to 2017. The reported rates of adverse reactions were overall 0.083–21.69%, separated into mild (1.24–17.65%), moderate (0.2–6%), and severe (0.04–0.59%). There were 1:100,000 to 1:220,000 deaths. Fluorescein concentration, volume injected, speed of injection, temperature, and contaminants were not correlated with the incidence of reactions. Patient characteristics including other comorbid diseases, allergy history, age, race, and gender showed only an increased rate of reaction in patients with a history of reaction to fluorescein. Although a number of studies examine techniques to reduce adverse reactions to intravenous fluorescein angiography, to date, the only proven method is reviewing allergy history, specifically a history of previous reaction to fluorescein.     

Adverse reactions in intravenous fluorescein angiography

Adverse reactions were noted in 241 (4.82%) of 5,000 consecutive intravenous fluorescein angiographies of the retina. The most frequent adverse reactions were nausea (2.24%), vomiting (1.78%), and urticaria/pruritus (0.34%). No life-threatening reactions were noted. No significant difference in the rate of adverse reactions was found when angiography using 10% fluorescein was compared with angiography using 25% fluorescein.     

血栓通联合羟苯磺酸钙治疗糖尿病视网膜病变导致的视野缺损

目的:探讨血栓通联合羟苯磺酸钙应用于糖尿病视网膜病变导致的视野缺损的临床疗效.方法:选取我院收治的糖尿病视网膜病变患者64例作为研究对象,将其随机均分为观察组和对照组,对照组采用血栓通进行治疗,观察组在上述治疗的基础上加用羟苯磺酸钙进行联合治疗.治疗5 mo后,比较两组糖尿病视网膜病变患者的临床疗效,治疗前后视野、荧光造影及眼底照相变化情况,观察患者的不良反应及复发情况.结果:两组患者的病情均明显好转,且观察组患者治疗有效率为97％,高于对照组的78％,差异比较有统计学意义(P＜0.05);观察组患者出血斑明显降低治疗前后比较有显著性差异,具有统计学意义(P＜0.05),观察组的视野灰度值、出血斑、血管瘤变化情况均明显优于对照组,具有统计学意义.观察组患者未出现不良反应,且复发率明显少于对照组,复发率比较有显著性差异(P＜0.05).结论:血栓通联合羟苯磺酸钙对糖尿病视网膜病变患者进行治疗,取得了比较满意的疗效,可以有效降低复发率,减少不良反应,显著改善临床症状,可在临床上推广应用.     

非动脉炎性视网膜中央动脉阻塞伴同侧颈内动脉闭塞患者的眼底影像特征

目的 探讨非动脉炎性视网膜中央动脉阻塞(NA-CRAO)伴同侧颈动脉闭塞患者的眼底影像特征。方法 回顾性研究。选择2019年11月至2021年11月在西安市人民医院(西安市第四医院)眼科住院治疗的NA-CRAO伴同侧颈内动脉闭塞患者32例32眼为颈内动脉闭塞组,选择同期住院治疗的NA-CRAO不伴有颈内动脉闭塞患者32例32眼为对照组。采用国际标准视力表检测患者最佳矫正视力(BCVA);对患者行瞳孔、眼球运动、裂隙灯显微镜、眼底彩色照相、OCT、荧光素眼底血管造影(FFA)、颈部血管超声多普勒、颅脑磁共振(MRI)、磁共振血管成像(MRA)检查。比较两组患者的臂-视网膜循环时间(A-Rct)、主干-末梢荧光素充盈时间(FT)、FFA特征、BCVA、眼底彩色照相、虹膜新生血管以及黄斑OCT特征。结果 颈内动脉闭塞组和对照组患者年龄、性别、眼别、发病时间以及高血压、糖尿病、高脂血症、高同型半胱氨酸血症患病率差异均无统计学意义(均为P>0.05);颈内动脉闭塞组患者A-Rct和FT较对照组均显著延长,差异均有统计学意义(P=0.016、0.003);颈内动脉闭塞组与对照组患者BCVA差...     

Oral fluorescein angiography: reassessment of its relative safety and evaluation of optimum conditions with use of capsules.

Injection of fluorescein intravenously for fundal angiography is associated with a high incidence of minor adverse effects (21%) but a very low incidence of serious (life threatening) reactions (0.05%). A serious reaction may occur without warning in a patient with no history of atopy. There are no reports of oral fluorescein causing a serious reaction, and minor adverse effects are uncommon. A study was undertaken to determine optimum conditions for oral fluorescein angiography. Capsules proved more convenient than a solution for ingestion of fluorescein. A dose of 25 mg/kg body weight produced good quality angiograms in 75% of the patients. The best pictures were obtained by photographing the fundus after 40 and 60 minutes.