增强CT检查患者应用静脉血管通路耐高压预警评分的效果观察

doi:10.16460/j.issn1008-9969.2019.12.069

摘要/Abstract

摘要： 目的探讨增强CT检查患者采用静脉血管通路耐高压预警评分的应用效果。方法选取2018年1-5月在我院接受增强CT检查的受检者7 660例。按登记时生成的ID尾号,单号者为对照组,双号者为观察组,每组各3 830例。对照组采用常规静脉治疗护理技术操作规范,观察组在对照组基础上采用静脉血管通路耐高压预警评分。观察比较2组患者静脉穿刺困难发生率、渗漏发生率、图像质量、碘对比剂全身不良反应发生率。结果观察组患者对比剂渗漏发生严重程度低于对照组（Z=2.532,P=0.011）,2组增强CT检查患者静脉穿刺困难发生率、图像质量、碘对比剂全身不良反应发生率比较差异均无统计学意义（P>0.05）。结论增强CT检查患者应用静脉血管通路耐高压预警评分,可降低其对比剂渗漏发生严重程度。

关键词: 静脉血管, 耐高压预警评分, 增强CT, 渗漏

Abstract: Objective To investigate the application of early warning scoring of high pressure tolerance in venous vascular access in patients with enhanced CT. Methods From January to May, 2018, 7,660 patients receiving enhanced CT examination in our hospital were selected as the study subjects. The patients with single ID number were included as the control group, and those with double number as the observation group, with 3,830 cases in each group. Nurses in the control group followed the routine nursing operation specifications of intravenous treatment and those in the observation group were required to follow the early-warning scoring of high pressure tolerance in venous vascular access when embedding indwelling needles in addition to routine operation. The incidence of venous puncture difficulty, leakage, image quality and systemic adverse reactions of iodine contrast agent were compared between the two groups. Results There were significantly less cases of leakage in the observation group (Z=2.532, P=0.011). There was no statistical significance in terms of incidence of venous puncture difficulty, image quality, and systemic adverse reactions of iodine contrast agent (P>0.05). Conclusion Enhanced CT leakage rate can be effectively reduced by applying early warning scoring of high pressure tolerance in venous vascular access.

Key words: venous access, warning scoring of high pressure tolerance, enhanced CT, leak rate

中图分类号:

R472.9

李定丽, 宋妍清, 周丹. 增强CT检查患者应用静脉血管通路耐高压预警评分的效果观察[J]. 护理学报, 2019, 26(12): 69-73.

LI Ding-li, SONG Yan-qing, ZHOU Dan. Application of Early Warning Scoring of High Pressure Tolerance in Venous Vascular Access in Patients with Enhanced CT[J]. Journal of Nursing, 2019, 26(12): 69-73.

参考文献

[1] 贾静,仇晓溪.整体干预治疗造影剂大量渗漏致骨筋膜室综合征的个案研究[J].护理研究,2010,24(2C):554-555.DOI:10.3969/1.issn.1009-6493.2010.06.053.
[2] Fedede M P,Chang P J,Confer S,et al.Frequency and Effects of Extravasation of Ionic and Nonionic CT Contrast Media During Rapid Bolus Injection[J]. Radiology,1998,206(3):637-640.
[3] Loth T S, Jones D E C. Extravasations of Radiographic Contrast Material in the Upper Extremity[J]. J Hand Surg,1988,13(3):395-398.
[4] 孙秀梅,卢蓉.增强CT检查中对比剂静脉渗漏进展[J].当代护士,2017(8):8-11.
[5] 黄超琼,曾勇明,陈洪玲,等.CT增强扫描检查中碘对比剂渗漏因素及相关性分析[J].重庆医学,2017,46(27):1389-3791.DOI:10.3969/j.issn.1671-8348.2017.27.014.
[6] 卢蓉,刘俊伶,赵丽,等.持续质量改进降低增强CT检查中碘对比剂的渗漏[J].西南国防医药,2015,25(12):1345-1347. DOI:10.39696.issn.1004-0188.2015.12.025.
[7] 王丽,张富强,何伟锋,等.儿童早期预警评分在意外伤害急诊患儿病情评估中的应用[J].护理学报,2015,22(16):55-58. DOI:10.16460/j.issn1008-9969.2015.16.056.
[8] 中华医学会放射学分会,中国医师协会放射医师分会.对比剂使用指南(第一版)[J].中华放射学杂志,2008,42(3):320-325.
[9] 熊恩平,邓洁.静脉腐蚀性药物输注外渗风险评估体系的构建[J].护理研究,2017,31(32):4082-4086.DOI:10.3969/j.issn.1009 6493.2017.32.013.
[10] 国家卫生计生委.静脉治疗护理技术操作规范[J].中国护理管理,2014,14(1):1-4.
[11] 梁雪芬,李素琳,洪蝶玫.神经内科患者静脉穿刺困难的原因分析及对策[J].中华现代护理,2010,16(24):2961.DOI:10.3760/cma.j.issn.1674-2907.2010.24.053.
[12] 王继琛,邱建星,孙晓伟.等.64层螺旋CT冠状动脉成像时心率对成像质量的影响[J].中国医学影像技术,2006,22(10):1481-1484.
[13] 李定丽,吴谨文,何永璐,等.CT增强时静脉穿刺困难原因分析及护理对策[J].医学信息,2013,9(26)4:282-283.
[14] 李雪,张伟国,刘霞,等.颈外静脉高压注射碘对比剂安全性的评价[J].中华现代护理杂志, 2012,18(19):2268-2271. DOI:10.3760/cma.j.issn.1674-2907.2012.19.012.
[15] 张而耕. 机械工程材料[M].上海:上海科学技术出版社,2017:10-13.
[16] 吴茜,龚美芳,孙晓,等.住院患者护理高危风险预警预控体系构建与运作[J].护理学报,2015,22(1):16-20.DOI:10.16460/j.issn1008-9969.2015.01.016.
[17] 钱根年,陈自谦,付丽媛,等,多层螺旋CT图像常见伪影的影响因素与解决方案[J].中国医学装备,2017,14(5):18-22. DOI:10.3969/J.ISSN.1672-8270.2017.05.006.
[18] 李萍,占杰,余晓锷.CT图像质量主要参数及其检测方法[J].放射学实践,2005,20(5):1-2.
[19] 郭启勇. 实用放射学[M]. 3版.北京:人民卫生出版社,2007:7-10.
[20] 陈韵岱,陈纪言,傅国胜,等.碘对比剂血管造影应用相关不良反应中国专家共识[J].中国介入心脏病学杂志,2014, 22(6):341-348. DOI:10. 3969/j. issn. 1004-8812.2014. 06.001.

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