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本文通过 1 1 0 0例高原CT增强扫描造影剂使用回顾 ,就高原上造影剂使用的几个问题加以讨论 ,意在加强对造影剂过敏反应及并发症的认识 ,提高造影剂使用的安全防范意识。我们认为 ,高原上使用造影剂应特别注意 :1、造影剂过敏试验一定要认真、准确。 2、观察过敏反应应仔细 ,特别是高原缺氧 ,使许多过敏反应症状不典型 ,临床容易疏忽。 3、严格掌握适应症 ,对过敏试验有任何不适主诉者原则上都不能使用离子型造影剂。 4、注重造影剂过敏反应的监控 ,特别要注意增强扫描后的迟发型反应。 5、造影剂过敏反应症状轻者 ,必须充分吸氧 ,尽快纠正缺氧 ,并肌注地塞米松1 0mg ,密切观察心跳、呼吸、血压。对重症反应者 ,必须采取强有力的抗过敏和抗休克措施 ,并争取临床医生配合抢救。 6、离子型和非离子型造影剂都有一定危险性 ,密切观察病人反应 ,早发现 ,早处理是安全使用造影剂的关键。 7、安全使用造影剂重在预防 ,如过敏体质、严重心肾功能不全都是潜在的危险因素。
In this paper, 110 cases of contrast-enhanced CT contrast scan of the plateau were reviewed to discuss the use of contrast media on the plateau. The purpose of this article is to enhance understanding of the allergic reaction and complications of contrast media and to improve the safety precautions awareness. We believe that the use of contrast agent on the plateau should pay special attention: 1, contrast agent allergy test must be serious and accurate. 2, observe the allergic reactions should be carefully, especially the plateau hypoxia, so that many allergic symptoms are not typical, clinical easily negligent. 3, strictly control the indications, any complaints of allergy test complained of in principle can not use ionic contrast agent. 4, pay attention to the contrast agent allergy monitoring, with particular attention to enhanced delayed type response after scanning. 5, mild contrast allergic reaction, oxygen must be fully, as soon as possible to correct hypoxia, and intramuscular dexamethasone 10mg, close observation of heartbeat, breathing, blood pressure. Severe responders, must take a strong anti-allergy and anti-shock measures, and seek cooperation with clinicians to rescue. 6, both ionic and non-ionic contrast agents have a certain risk, close observation of patient response, early detection, early treatment is the key to the safe use of contrast media. 7, the safe use of contrast agents focused on prevention, such as allergies, severe heart and kidney dysfunction are potential risk factors.