二氧化碳在数字减影血管造影中的临床应用

目的研究二氧化碳在不同部位的血管造影中的临床应用效果及其安全性。方法対52例患者分别行不同部位的血管共70次二氧化碳数字减影血管造影(CO2-DSA)。其中腹主动脉18次,下肢动脉14次(髂总-胫、腓动脉),下肢静脉10次,肝动脉10次,肾动脉10次,肠系膜上动脉4次,盆部动脉4次。同时给予同一患者碘造影比较。术中采用心电血压监护及检测氧饱和度。每次造影后询问有何不适,根据ADRS轻重分为0~4分(0=无不适;4=重度不适,对症处理不能缓解或出现并发症)。结果①在10例肝动脉造影中亚段以下动脉、肿瘤动脉及肿瘤染色不如碘造影好;②其余部位的血管造影都能获得满意的图像,基本满足诊断及治疗的要求;③所有患者都出现不同程度的药品不良反应(ADR s)。40例(76.9%)为一过性,可自行缓解;12例(23%)对症处理后迅速缓解;全组未出现严重的并发症。结论①CO2-DSA可以获得能基本满足诊断要求的图像;②CO2是一种安全的血管造影剂;③CO2下肢动脉造影可以替代碘造影。

Clinical application of CO2-digital substruction angiography

Objective To study the clinical ultility and safety of carbon dioxide gas as a vascular contrast agent.Methods Carbon dioxide digital substrction angiography(CO2-DSA) was performed in 52 patients for 70 times.Abdominal arteriography was performed for 18 times,lower extremity arteriography for 14 times,lower extremity phlebography for 10 times,hepatic arteriography for 10 times,renal arteriography for 10 times,superior mesenteric arteriography for 4 times,pelvic arteriography for 4 times.The image quality of CO2-DSA was compared with that of iodinatied contrast media DSA.Oxygen saturation were monitored.Patients were questioned about discomfort or complication during the examinations.The scale from 0 to 4 was adapted to evaluate the extension of discomfort(0=note;4=severe discomfort or complication).Results 1.In 10 cases CO2-DSA was inferior to conventional angiography in lower branches of hepatic arteriography and tumor stains.2.Image quality was satisfying in other angiography.3.Adverse drug reactions(ADRs) were presented in all cases.ARDs in 40 cases(76.9%)were temporary,and relieved without treatment;12 cases with ARDS alleviated rapidly after heteropathy;no severe complication was found in all cases.Conclusion 1.CO2-DSA could provide satisfying images.2.CO2 is a safe vascular contrast agent.3.CO2-DSA could take place of conventional angiography in lower extremity arteriography.