Source: Chinese Medicine Innovation

Abstract Objective: To investigate the high-pressure syringe in enhanced helical CT angiography in the operation and care.

Methods: 467 cases of patients receiving enhanced helical CT angiography of the tube for the study, are high-pressure syringe and injection needle, and the success rate was observed adverse reactions, specific care measures. Results: 467 cases of patients with high pressure syringe enhanced helical CT angiography, the one-time successful puncture 463 cases, the success rate 99.14qe; 9 cases of leakage of contrast bolus of contrast agent process, leakage rate 1.93%. 467 cases of serious complications in patients with phlebitis, air embolism occurred.

Conclusion: The careful preparation in enhanced spiral CTm tube angiography, the proper use of high-pressure injector, intensive care, can reduce the contrast agent leakage, prevent adverse reactions.

Key words high-pressure injector; spiral CP; enhanced scan; Care

With the wide application of computer tomography technology, high-pressure injector also been used in enhanced helical CT angiography in. Due to the high-pressure injector can accurately control the amount of contrast agent injection, speed and time, so be enhanced tubes get much of scanning, dynamic results clearer, higher detection rate of lesions, diagnosis more precise n1. In the enhanced spiral CT angiography in the high-pressure syringe p puncture technique, care punctured affect the scan results. This paper selects 467 cases with high pressure syringe enhanced helical CT angiography examination by the patients in this study to explore the puncture methods of operation and the related nursing measures, it is reported below.

Materials and Methods

1.1 - General information selected in April 2010 - December 2013 to the hospital hyperbaric chamber syringe CT 16-slice CT angiography enhanced 467 patients for the study, 285 cases were male, female 182 cases; aged 6 -72 years, mean (41.4 ± 5.69) years. In this study, approved by the hospital ethics committee. 1.2 (1) equipment and drug preparation: Philips 16-slice CT machine and de leap MEDTRONCT syringes, ready to disposable scalp needle (21C) and disposable intravenous catheter (20GA). Drugs, including non-ionic contrast agent: ioversol injection, iohexol injection, dexamethasone and 0.9% sodium chloride. (2) selection and vascular puncture: Since enhanced helical CT angiography scan requires the injection of a sufficient amount of contrast agent in a short time, and the flow rate through the contrast agent must be high, so high-pressure syringe should choose cubital vein puncture diameter thick, straight and elastic artery puncture. Help patients lying in bed checking, regular disinfection of the skin puncture site will 2IC--time scalp needle puncture of the skin was 15. -30. Oblique piercing the vein. After see the return of blood to continue the needle about 5-10mm, properly fixed with adhesive tape, after connecting dexamethasone dilution 10mL pressure syringe. Young children and critically ill patients with intravenous catheter. (3) set the parameters: by intravenous bolus injection, adult total contrast agent is 60-100mL + saline 30-50mL, children 1.5-2.0mL / kg; angiographic injection rate 3.5-5.0mUs. (4) Nursing: Through careful preparation before contrast, improve the success rate, strengthen the contrast in care.

1.3 OUTCOME MEASURES pressure syringe puncture in all patients and enhance the success rate of adverse reactions occurred during the scan.

2 Results

2.1 success rate in patients with 467 cases of high pressure syringe enhanced helical CT angiography, the one-time successful puncture 463

Cases, the success rate of 99.140- / 0; 9 cases of leakage of contrast bolus of contrast agent process, leakage rate 1.930- / 0, after timely treatment did not cause serious complications.

2.2 Adverse reactions with high pressure syringe injection of contrast agent, 123 cases of patients with dry mouth, throat tightness and other symptoms, the incidence of 26.34%: 8 cases (1.71%), nausea in patients, five cases (1.070- / 0) patients pruritus, NES treatment, spontaneous remission of symptoms after scanning; one case (0.21%) patients with chest tightness, heart rate, hives and other reactions, the anti-allergy treatment remission; 467 cases occurred in patients with phlebitis, air embolism and other serious complications. Table 1. Table 1 Adverse reactions observed in the high-pressure syringe enhanced helical CT angiography in

3 Care

Spiral CT scan results directly affect image quality, determine the qualitative and the diagnosis and treatment of disease lesions. Pressure injector is an automated injection equipment, high-pressure syringe by intravenous bolus contrast agent enhanced spiral CT scan, is controlled by a computer system, the time and the speed is set according to the actual situation of the patient and on different parts of angiography procedures set and adjusted to ensure that the concentration of the contrast agent, the effect of accurate and reliable, high diagnostic quality, and the operation is simple and fast. But cao xiaohong noted that the use of high-pressure syringe injection of contrast agent due to pressure, injection speed, prone to needle loss, extravasation of contrast, cause a series of adverse reactions. So we should strengthen the use of high-pressure syringe care, to ensure enhanced helical CT examination success. (L) preparation prior to injection: history, especially asked in detail about whether the contrast agent allergies. Strengthen psychological care before injection to inform enhanced scan of purpose, meaning, indicating the use of contrast agents related reactions may occur, so that patients make the necessary psychological preparation. After guiding patients take the appropriate position, taking the scalp of contrast agent connected with high pressure syringe needle, cold season warming the contrast agent appropriate to improve patient tolerance. Setting contrast agent based on the total amount of the actual situation of the patient and the injection speed. Due to the presence of contrast agent allergic reactions and other adverse reactions, therefore CT examination room should prepare in advance emergency medicine and first-aid equipment, once an allergic reaction occurs, immediately place the rescue. (2) the time of injection treatments: Success should be properly fixed after a puncture needle, the first hand-bolus to scold agents 3-5mL, observe the puncture site for leaks, spills occur once the contrast agent, the injection should be stopped immediately, After re-puncture needle injection replace the injection site. After determining no leakage, then use high-pressure syringe injection. Enhanced scanning process after injection 30-40mL, nurses should leave the scanning, but whether patients should be closely observed allergies and other adverse reactions, at any time to get ready. Care (3) angiography after: angiography after the end of patient is asked to press the puncture site properly before leaving the CT room 5-10min observed after 20min no exception. As a result of leakage of contrast agents cause local swelling, the patient is asked Taigaohuanzhi topical 500/0 magnesium sulfate wet. At the same time asked the patient a lot of water, in order to accelerate the contrast agent through the urine excretion.