Practical Preventive Strategies for Extravasation of Contrast Media During CT: What the Radiology Team Should Do
Practical Preventive Strategies for Extravasation of Contrast Media During CT: What the Radiology Team Should Do
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DOI：
10.1016/j.acra.2022.01.007
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发表时间：
2022-10-01
影响因子：
4.8
通讯作者：
Hirai, Toshinori
中科院分区：
文献类型：
--
作者：
Shigematsu, Shinsuke;Oda, Seitaro;Hirai, Toshinori
基本原理和目的：本研究旨在评估我们的放射科团队(放射科护士、放射科技师、放射科医生)采取的实用预防措施(即静脉脆弱性评估和预防性扫描规程规则)在减少CT扫描中造影剂外溢方面的有效性。材料和方法：回顾分析2013年1月至2019年12月期间接受CT增强扫描的73,931例患者。放射科团队于2015年开始进行静脉脆弱性评估，2017年增加了预防ECM的预防扫描方案规则。我们将每个时期定义为：2013-2014年，无预防(A期)；2015-2016年，早期预防(B期，仅静脉脆弱性评估)；2017-2019年：晚期预防(C期，预防性扫描方案规则的静脉脆弱性评估)。回顾了事件报告、放射学报告和发生ECM的患者的医疗记录。结果：ECM发生率为0.39%(292/73,931)。A、B、C期的ECM频率分别为0.62%(121/19,505)、0.43%(89/20,847)和0.24%(82/33,579)。三个时期的ECM发生率差异有统计学意义(卡方检验，p<；0.01)。结论：由放射科团队实施静脉脆弱性评估和预防性扫描方案规则是降低CT期间ECM风险的一种实用而简单的解决方案。
Rationale and Objectives: This study aimed to assess the effectiveness of practical preventive strategies (i.e., venous vulnerability assessment and prevention scan protocol rules) taken by our radiology team (radiology nurses, radiology technicians, radiologists) on reducing extravasation of contrast media (ECM) during CT.Materials and Methods: A total of 73,931 patients who underwent contrast-enhanced CT scans between January 2013 and December 2019 were retrospectively included. Venous vulnerability assessment by the radiology team began in 2015, and prevention scan protocol rules for the prevention of ECM were added in 2017. We defined each period as follows: 2013-2014, no prevention (Period A); 2015-2016, early prevention (Period B, venous vulnerability assessment only); and 2017-2019: late prevention (Period C, venous vulner-ability assessment with prevention scan protocol rules). The incident reports, radiology reports, and medical records of patients in whom ECM occurred were reviewed. We compared the frequency of ECM during each period.Results: ECM occurred in 0.39% (292/73,931) of the patients. The frequencies of ECM for Periods A, B, and C were 0.62% (121/19,505), 0.43% (89/20,847), and 0.24% (82/33,579), respectively. There were significant differences in the frequencies of ECM among the three periods (Chi-squared test, p < 0.01).Conclusion: Implementation of venous vulnerability assessment and prevention scan protocol rules by a radiology team can be a practi-cal and simple solution to reduce the risk of ECM during CT.