非离子型造影剂碘过敏反应的预防和处理

目的：对比观察非离子型造影剂优维显在CT增强扫描中的副反应。探讨其机理及临床应用价值。材料与方法：观察受检人数2109例，男1329例，女780例。药物为德国先灵公司生产非离子型造影剂300mgl／ml优维显。造影剂剂量50～80ml，婴幼儿按公斤体重计算(新生儿4ml／kg，婴儿3ml／kg，幼儿1．5ml／kg)。美国MCT／MCTPLUS高压自动注射器，注射速度2～3ml／s，荷兰philip公司Tomoscan，AV．EPPLUS高速螺旋CT。结果：严重过敏性休克4例，占0．19％；碘过敏试验阳性( )26例，占1．2％．其中2例碘试验严重过敏性休克。碘过敏试验(-)，也出现不同程度反应：重度过敏性休克2例，占0．09％；中度21例，占0．99％；轻度40例，占1．8％。结论：非离子型造影剂增强扫描前要认真按常规做好碘过敏试验，碘过敏试验有一定的预测价值。值得注意的是非离子型造影剂也不是绝对安全，少数患者也会有不同程度过敏反应。

The Observation and Nursing of the Patients with Allergy in CT Contrast Enhancement

Purpose:To observe the side effect of non-inonic contrast media (Ultravist) in CT contrast enhancement and discuss its mechanism and clinic value.Materials and Methods:2019 patients were observed,including 1329 men and 780 women.The non-ionic contrast media we used is Ultravist which is made in Germany.The dose of contrast media for adult is 300mgI/ml 50-80ml;for neonates,it must be calculated by the weight(newborns 4ml/kg,babies 3ml/kg,infants 1 5ml/kg).The type of high pressure injector is MCT/MCTPLUS,which is made in America.The inject speed is 2-3ml/s.The type of CT machine is philip Tomoscan,AV.EP PLUS,which is made in Holand.Results:4 patients had severe allergic shock,which occupy 0 18%;26 patient were positive in iodin allergy test,which occupy 0 12%.And different reaction were occured during the CT contrast enhancement examination in patients with negative iodine allergy test:2 patients had severe allergic shock,which occupied 0 09%;21 had moderate reaction,which occupied 0 99%;and 40 had mild reaction,which were occupied 1 8%.Conclusion:The iodin allergy test must be well done before the CT contrast enhancement examination though it has some value in predicting allergic reactions.But the non-ionic contrast media isn't absolutely safeied and a few patients will have different reation to it.