目的 探讨肺癌伴癌性疼痛患者心理僵化现状及其影响因素,为临床制定改善患者心理僵化的针对性干预措施以及提升患者生活质量提供参考依据。方法 采用便利抽样法,选取2023年10月—12月期间焦作市某三级甲等医院收治的肺癌伴癌性疼痛患者为研究对象,采用一般资料调查问卷、疼痛心理僵化量表(PIPS)、简易疾病感知问卷(BIPQ)、家庭功能问卷(APGAR)进行调查,采用Pearson相关性分析肺癌伴癌性疼痛患者心理僵化与疾病感知、家庭功能的关系。采用多元线性回归分析肺癌伴癌性疼痛患者心理僵化的影响因素。结果 本次研究共发放问卷152份,回收有效问卷150份,有效回收率为98.68%。150例肺癌伴癌性疼痛患者心理僵化量表总分为(61.66±2.85)分,回避型经验维度得分为(45.52±1.97)分,认知融合维度得分为(19.74±1.59)分。不同文化程度、家庭人均月收入、疼痛程度的肺癌伴癌性疼痛患者心理僵化得分比较,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示:肺癌伴癌性疼痛患者心理僵化总分、经验性回避维度得分、认知融合维度得分与疾病感知得分均呈正相关关系(P<0.001),与家庭功能得分均呈负相关关系(P<0.001)。多元线性回归结果显示:文化程度、家庭人均月收入、疾病感知、家庭功能是肺癌伴癌性疼痛患者心理僵化的影响因素(P<0.05),可解释肺癌伴癌性疼痛患者心理僵化43.9%的变异度。结论 肺癌伴癌性疼痛患者心理僵化处于较高水平,且受到文化程度、家庭人均月收入、疾病感知和家庭功能的影响,临床医护人员可从疾病感知、家庭支持等角度出发,采用认知干预、同伴支持等方法,加强对患者的健康教育,以缓解其对疾病的负性认知,从而缓解心理僵化,促进身心健康恢复。
Objective To explore the status and influencing factors of psychological rigidity in patients with lung cancer and cancer pain,and to provide reference for clinical development of targeted interventions to improve patients’psychological rigidity andquality of life.Methods The convenience sampling method was used to select patients with lung cancer and cancer pain who were admitted to a tertiary hospital in Jiaozuo City from October to December 2023 as the research object.The general data questionnaire,Psychological Inflexibility in Pain Scale(PIPS),Brief Illness Perception Questionnaire(BIPQ),and family function questionnaire(APGAR)were used to investigate.Pearson correlation analysis was used to analyze the relationship between psychological rigidity and disease perception and family function in patients with lung cancer and cancer pain.Multivariate linear regression was used to analyze the influencing factors of psychological rigidity in patients with lung cancer and cancer pain.Results A total of 152 questionnaires were distributed in this study,and 150 valid questionnaires were recovered,with an effective recovery rate of 98.68 %.The total score of PIPS of 150 patients with lung cancer and cancer pain was(61.66±2.85),the score of avoidance experience dimension was(45.52±1.97),and the score of cognitive fusion dimension was(19.74±1.59).There were statistically significant differences in the scores of psychological rigidity among lung cancer patients with cancer pain with different educational levels,family per capita monthly income,and pain degree(P<0.05).The results of Pearson correlation analysis showed that the total score of PIPS,the score of empirical avoidance dimension and the score of cognitive fusion dimension were positively correlated with the score of disease perception(P<0.001),and negatively correlated with the score of family function(P<0.001).The results of multiple linear regression showed that education level,family per capita monthly income,disease perception and family function were the influencing factors of psychological rigidity in patients with lung cancer and cancer pain(P<0.05 ),which could explain 43.9 % of the variation of psychological rigidity in patients with lung cancer and cancer pain.Conclusions The psychological rigidity of lung cancer patients with cancer pain is at a high level,and is affected by education level,family per capita monthly income,disease perception and family function.Clinical medical staff can use cognitive intervention and peer support from the perspective of disease perception and family support to strengthen the health education of patients,so as to alleviate their negative cognition of the disease,to alleviate the psychological rigidity and promote the recovery of physical and mental health.
目的 探讨营养评估及炎症因子水平对非霍奇金淋巴瘤(NHL)患者化学治疗(化疗)后感染及平均住院日的影响。方法 回顾性分析接受R-CHOP治疗的NHL患者95例。通过受试者工作特征(ROC)曲线确定患者主观整体营养评估(PG-SGA)预测患者化疗后感染的界值。将患者分为PG-SGA<4组与PG-SGA≥4组,比较两组间营养及炎症相关指标的差异。采用单因素与多因素回归分析NHL患者化疗后感染及平均住院日延长的危险因素。结果 ROC曲线显示PG-SGA为3.5时,约登指数最大,预测NHL患者化疗后感染灵敏度为92%,特异度为11.1%。PG-SGA≥4组患者平均年龄、国际预后指数(IPI)及Ann arbor Ⅲ~Ⅳ期比例均高于PG-SGA<4组(P<0.05)。与PG-SGA<4组相比,PG-SGA≥4组患者白介素6(IL-6)及中性粒细胞与淋巴细胞比值(NLR)明显升高,且化疗后感染率及平均住院日≥5 d比例高于对照组(P<0.05);与对照组相比,PG-SGA<4组患者前白蛋白、白蛋白和血红蛋白水平升高(P均<0.05)。多因素回归分析显示,PG-SGA≥4及合并糖尿病是NHL患者化疗后感染率的独立危险因素(P均<0.05)。白蛋白低于35 g/L及合并化疗后感染是NHL患者平均住院日延长的独立危险因素(P均<0.05)。结论 基于PG-SGA的营养评估及炎症因子分析对NHL患者化疗后感染及平均住院日的预测具有临床指导意义。
Objective To explore the effects of nutritional assessment and inflammatory factor levels on post-chemotherapy infections and length of hospital stay in patients with non-Hodgkin’s lymphoma(NHL).Methods A total of 95 NHL patients treated with the R-CHOP regimen were retrospectively analyzed.The cut-off value of Patient-Generated Subjective Global Assessment (PG-SGA) for post-chemotherapy infection in NHL patients was evaluated by Receiver Operating Characteristic(ROC)curves.Patients were categorized into PG-SGA<4 and PG-SGA≥4 groups and compared for differences of nutritional and inflammation-related factors.Univariate and multivariate logistic regression were used to analyze the risk factors for post-chemotherapy infection and length of hospital stay(LHS).Results The ROC curve showed that the Youden index was largest at PG-SGA of 3.5,which predicted post-chemotherapy infection in NHL patients with a sensitivity of 92% and a specificity of 11.1%.The mean age,International Prognostic Index(IPI),and Ann Arbor stage Ⅲ~IV proportion in patients with PG-SGA≥4 were higher compared with the control(P<0.05).Patients with PG-SGA≥4 had significantly higher interleukin-6 and neutrophil-to-lymphocyte ratio(NLR),and the infection rate and the proportion of LHS≥5 days after chemotherapy were higher than those in the control group(P<0.05).Patients in the PG-SGA<4 group had significantly higher prealbumin,albumin,and hemoglobin levels compared to the PG-SGA≥4 group(P<0.05).Multifactorial logistic regression analysis revealed that PG-SGA≥4 and combined diabetes mellitus were independent risk factors for post-chemotherapy infection rate in NHL patients(both P<0.05).Albumin less than 35 g/L and combined post-chemotherapy infection were independent risk factors for prolonged LHS in NHL patients(both P<0.05).Conclusions PG-SGA nutritional assessment and inflammatory factor analysis are clinically instructive in predicting post-chemotherapy infections and LHS in NHL patients.
脓毒症当前仍然是全球范围内重要的医疗卫生问题,其对世界公共卫生及患者安全带来重大威胁。脓毒症是指宿主对感染反应失调引起的危及生命的器官功能障碍, 其发病率和病死率均极高,是临床重症医学中的重大挑战。在脓毒症病情的进展过程中, 可出现组织灌注不足、血流动力学不稳定等变化, 从而导致多器官功能受损,而心脏是常见的被累及的重要靶器官之一, 这种由脓毒症所导致的不同程度的心肌损伤, 被称为“脓毒性心肌病”, 其发生和发展机制复杂多样, 涉及循环心肌抑制因素、心肌自身因素及自主神经失调等多个方面。文章综述了脓毒症患者发生心肌损伤的高危因素, 以期为临床治疗和预防提供参考。
Sepsis currently remains an important global healthcare issue, and a major threat to world public health and patient safety.Sepsis is a life-threatening organ dysfunction caused by dysregulation of the host response to infection, with extremely high morbidity and mortality,which is a major challenge in clinical critical care medicine.During the progression of sepsis, changes such as inadequate tissue perfusion and haemodynamic instability may occur, leading to impairment of multiple organ functions, while the heart is one of the commonly involved vital target organs, and the varying degree of myocardial damage caused by sepsis is known as “septic cardiomyopathy”.The mechanisms of its occurrence and development are complex and diverse, involving circulating myocardial inhibitory factors, myocardial auto-factors, and autonomic dysregulation.In this paper, we review the high-risk factors for myocardial injury in septic patients, providing a reference for clinical treatment and prevention.
目的 探讨广州市越秀区青少年近视特点和危险因素,为降低青少年近视发病率提供参考依据。方法 本项目采用分层随机整群抽样的研究方法,抽取分布于广州市越秀区2 774名青少年作为研究对象,根据近视检查情况将其分为近视组(n=1 657)与非近视组(n=1 117),通过问卷调查的方式,分析青少年近视整体现况、流行病学特征以及影响青少年近视发生、发展的相关行为和因素。结果 2 774名青少年中,1 657名近视,检出率为59.73%;其中女生为872名,多于男生的785名;幼儿园、小学生、初中生、高中生近视人数分别为20名、446名、484名、707名,呈升高趋势。学段、校内用眼环境、校外用眼环境、读写姿势、电子屏幕使用情况、近距离用眼情况、户外活动及睡眠情况、近视检查及矫治情况是广州市越秀区青少年近视的影响因素(P<0.05)。广州市越秀区青少年近视程度均与学段、校外用眼环境、电子屏幕使用情况、户外活动及睡眠情况、近距离用眼情况呈正相关(P<0.05),与校内用眼环境、读写姿势、近视检查及矫治情况呈负相关(P<0.05)。对不同预后组间存在统计学差异的因素进行Logistic多因素分析后得到,学段、校内用眼环境、校外用眼环境、读写姿势、电子屏幕使用情况、近距离用眼情况、户外活动及睡眠情况、近视检查及矫治情况是广州市越秀区青少年近视的相关影响因素(P<0.05)。结论 广州市越秀区青少年近视发生人群呈现高龄化,学段、校内用眼环境、校外用眼环境、读写姿势、电子屏幕使用情况、近距离用眼情况、户外活动及睡眠情况、近视检查及矫治情况是青少年近视的相关影响因素,建议加强组织学生到户外进行多种课间户外体育活动,同时鼓励家长在校外从自身做起,树立爱眼护眼好榜样,与学校共同保护孩子的视力。
Objective To explore the characteristics and risk factors of myopia among adolescents in Yuexiu District,Guangzhou,and to provide reference for reducing the incidence of myopia among adolescents.Methods This project adopted stratified random cluster sampling to select 2 774 adolescents distributed in Yuexu District,Guangzhou as the research objects,which were divided into myopia group(n=1 657)and non-myopia group(n=1 117)according to the myopic examination.Through questionnaire survey,the overall situation and epidemiological characteristics of myopia among adolescents in our district were comprehensively known,in order to explore the related behaviors and factors affecting the occurrence and development of myopia among adolescents in our district,explore reasonable intervention measures,and put forward scientific and effective myopia prevention and control technical means and strategies.Results Among 2 774 adolescents,1 657 were nearsighted(59.73%).Among them,872 were female and 785 were male.The number of myopia in kindergarten,primary school,middle school and high school students were 20,446,484 and 707 respectively,showing an increasing trend.School period,eyes use environment in school and outside school,reading and writing posture,situations of electronic screen use,close distance eye use,outdoor activities and sleep,myopia examination and correction were the relevant influencing factors on myopia of adolescents in Yuexui District of Guangzhou(P<0.05).The myopia degree of adolescents in Yuexiu District of Guangzhou was positively correlated with school period,out-of-school eyes use environment,electronic screen use,outdoor activities and sleep conditions,and close distance eyes use(P<0.05),and negatively correlated with in-school eyes use environment,reading and writing posture,myopia examination and correction conditions(P<0.05).After Logistic multivariate analysis of the factors with statistical difference between different prognostic groups,school period,eyes use environment in school and outside school,reading and writing posture,electronic screen use,close distance eyes use,outdoor activities and sleep conditions,myopia examination and correction were the relevant influencing factors on myopia of adolescents in Yuexui District of Guangzhou(P<0.05).Conclusions In Yuexiu District,Guangzhou,the population with myopia is gradually moving to a younger age.School period,eyes use environment in school and outside school,reading and writing posture,electronic screen use,close distance eyes use,outdoor activities and sleep condition,myopia examination and correction are the relevant influencing factors.It is recommended to strengthen the organization of students to go outdoors for a variety of outdoor sports activities between classes,while encouraging parents to set a good example of eye care outside the school and work with the school to protect their children’s eyesight.
目的 了解脑出血患者家属参与治疗共享决策满意度现状及其影响因素,为提升脑出血患者的护理质量和家属体验提供参考。方法 采用横断面研究设计,便利抽取2022年1月—2023年7月许昌中医院收治的脑出血患者及其家属进行问卷调查。结果 共回收问卷178份,全部纳入分析。患者家属参与医疗决策的满意度得分为(48.58±6.34)分,其中维度得分最低的为交流协商。多因素分析结果显示,家属教育程度、家属年龄、家庭总年收入以及患者家属对医疗决策知情程度为患者家属参与医疗决策满意度的影响因素(F=30.872,P<0.001),解释40.3%的变异。结论 脑出血患者家属参与治疗共享决策满意度处于中等水平,患者家属对医疗决策知情程度越高、家属教育程度越高、家属年龄较大以及家庭总年收入越高的脑出血患者家属参与治疗共享决策满意度越高。
目的 调查儿童川崎病(KD)冠状动脉损伤发生情况,并进行危险因素分析。方法 选择2018年1月—2022年12月在泉州市妇幼保健院儿童医院诊治的KD儿童782例为研究对象,所有患儿在入院时均给予超声检查,判定冠状动脉损伤情况,调查所有患儿的一般资料,进行危险因素分析。结果 782例患儿中,超声判断为冠状动脉损伤171例,占比21.9%(冠脉损伤组),无冠状动脉损伤611例(无冠脉损伤组)。冠脉损伤组的皮疹、肢端硬性红肿、球结膜充血、杨梅舌等临床表现占比分别为83.6%、67.8%、86.0%、81.9%,高于无冠脉损伤组的63.5%、49.7%、62.5%、65.3%(P<0.05)。冠脉损伤组与无冠脉损伤组的性别、年龄、血红蛋白、血红细胞沉降率(ESR)等比较差异无统计学意义(P>0.05),冠脉损伤组的丙氨酸氨基转移酶、白细胞计数(WBC)、D-二聚体(D-D)、C-反应蛋白(CRP)、降钙素原(PCT)、血小板计数(PLT)、发热时间与无冠脉损伤组比较差异有统计学意义(P<0.05)。多因素Logistic逐步回归分析显示,WBC、D-D、CRP、PCT、PLT、发热时间均为川崎病患儿发生冠状动脉损伤的影响因素(P<0.05)。结论 KD儿童中,冠状动脉损伤发生率较高,可导致患儿临床特征多样化,加重患儿的病情,WBC、D-D、CRP、PCT、PLT、发热时间为导致冠状动脉损伤发生的影响因素。
Objective To investigate the incidence of coronary artery injury in children with Kawasaki disease(KD)and analyze the risk factors.Methods From January 2018 to December 2022,782 children with KD diagnosed and treated in Quanzhou Women’s and Children’s Hospital were selected as the study subjects.All the children were given ultrasound examination on admission to determine the coronary artery injury level.The general information of all the children was investigated and the risk factors were analyzed.Results Among the 782 children,171 cases(21.9%)were diagnosed as the“coronary artery injury group”.The remaining 611 patients did not exhibit any coronary artery injury and were thus categorized as the“no coronary artery injury group”.The clinical manifestations incidences of rashes,hard red swelling of extremity,bulbar conjunctival congestion and bayberry tongue in the coronary injury group were 83.6%,67.8%,86.0% and 81.9%,respectively,which were significantly higher than those in the non-coronary injury group(63.5%,49.7%,62.5% and 65.3%,P<0.05).There were no significant differences in gender,age,hemoglobin and erythrocyte sedimentation rate between the coronary injury group and the no coronary injury group(P>0.05).There were significant differences in alanine aminotransferase,white blood cell count(WBC),D-dimer(D-D),C-reactive protein(CRP),procalcitonin(PCT),platelet count(PLT)and fever duration between the two groups(P<0.05).Multivariate Logistic stepwise regression analysis showed that WBC,D-D,CRP,PCT and PLT were all important factors leading to coronary artery injury(P<0.05).Conclusions The incidence of coronary artery injury in children with KD is relatively high,which can lead to the diversification of clinical features and disease aggravation of children.WBC,D-D,CRP,PCT,PLT and fever duration are important risk factors for the occurrence of coronary artery injury.
目的 分析广州某三甲医院脑梗死患者住院费用的变化以及影响因素,为有效减轻患者疾病经济负担提供参考依据。方法 提取广州某三甲医院2015—2022年出院诊断ICD-10前三位编码为I63的病案首页数据,并采用IBM SPSS 20.0软件对费用结构进行描述性统计分析,以多重线性回归分析患者住院费用的影响因素。结果 2015—2022年脑梗死患者的平均住院费用年均增长率为2.86%;费用结构以药品费为主,占比逐年下降,至2022年占比为27.74%,技术劳务性费用占比逐年增加,至2022年占比为47.41%;住院费用主要受医院感染情况、住院天数以及支付方式等因素影响(F=990.10,P<0.001)。结论 脑梗死患者的住院费用结构显著优化,但患者的疾病经济负担仍然较重,且费用受多种因素的综合影响。建议通过提高医疗质量与服务效能,并严格落实临床路径管理,减少不必要的检查以及耗材使用,以期最大程度地减轻患者的负担。
Objective To analyze the structural changes and influencing factors of the hospitalization expenses for patients with cerebral infarction in a tertiary general hospital in Guangzhou,and provide a scientific basis for reducing economic burden of the patients.Methods The front page data of medical records with the main diagnosis of I63 were collected in the sample hospital.Descriptive statistics analysis of hospitalization expenses structure and multiple linear regression analysis of the influencing factors were carried out by SPSS 20.0.Results The annual growth rate of average hospitalization expenses of cerebral infarction patients from 2015 to 2022 in the sample hospital was 2.86% per year.The highest proportion of hospitalization expenses was medicine fee,the proportion of which declined year by year with a minimum 27.74% in 2022.The proportion of technical labor costs accelerated year by year with a maximum 47.41% in 2022.This study revealed the main factors influencing hospitalization expenses were hospital internal infection or not,length of stay,payment method and so on(F=990.10,P<0.001).Conclusions The structure of hospitalization expenses for cerebral infarction patients was significantly optimized,but the economic burden of patients was still heavy affected by a combination of factors.In order to minimize the burden of patients,hospitals should improve medical quality and service efficiency and implement clinical pathway management strictly,to reduce unnecessary inspections and consumables.
目的 了解危重产妇代理决策者的决策困境现状及其影响因素。方法 选择2022年10月—2023年10月许昌市中心医院产科及ICU的262例危重产妇及其代理决策者作为研究对象。应用一般资料问卷、母婴健康素养问卷、决策困境量表、决策参与期待量表进行调查。结果 决策困境量表总分为(39.38±14.58)分,其中信息提供和价值观明确总分为(13.91±7.16)分、社会支持和决策有效性总分为(20.41±8.25)分、不确定性总分为(5.06±1.96)分。多元线性回归分析发现,性别、学历、决策时间和脑卒中防治知识总分对危重产妇代理决策者决策困境均有影响(P<0.05)。结论 危重产妇代理决策者存在决策困境,医护人员需要根据代理决策者的人口学特征、疾病防治知识以及患者疾病特征进行决策辅助,减轻其决策困境,提升决策质量。
Objective To understand the current situation and influencing factors of decision-making difficulties among surrogate decision-makers for critically ill puerpera.Methods A total of 262 critically ill puerpera and their surrogate decision-makers from the obstetrics and ICU of Xuchang Central Hospital from October 2022 to October 2023 were selected.A survey was conducted using the General Information Questionnaire,Maternal and Child Health Literacy Questionnaire,Decision Dilemma Scale,and Decision Participation Expectancy Scale.Results The total score of the Decision Dilemma Scale was(39.38±14.58),with a total score of(13.91±7.16)for information provision and clear values,(20.41±8.25)for social support and decision effectiveness,and(5.06±1.96)for uncertainty.Multiple linear regression analysis found that gender,education level,decision time and total score of stroke prevention and control knowledge all have an impact on the decision-making difficulties of surrogate decision-makers in critically ill puerpera(P<0.05).Conclusions There is a decision-making dilemma for the surrogate decision-makers of critically ill puerpera.Medical staff need to provide decision-making assistance based on the demographic characteristics,disease prevention and control knowledge,and patient disease characteristics of the surrogate decision-makers,in order to alleviate their decision-making difficulties and improve the quality of decision-making.
目的 研究影响新生儿低血糖的相关危险因素。方法 回顾性分析新生儿科570例新生儿的临床资料,其中新生儿低血糖组190例,正常血糖组新生儿380例,采用Logistic回归分析新生儿低血糖相关危险因素。结果 单因素Logistic回归分析显示,新生儿体质量减轻、早产、新生儿呼吸衰竭、新生儿呼吸窘迫、新生儿感染、母亲分娩年龄增大、经产妇、剖宫产、双胎、妊娠期糖尿病、妊娠期高血压疾病是新生儿低血糖发生的危险因素(均P<0.05);多因素Logistic回归分析显示,早产(OR=2.115,95%CI:1.186~3.772)、剖宫产(OR=6.92,95%CI:4.202~11.397)是新生儿低血糖发生的危险因素(均P<0.05)。结论 早产、剖宫产是新生儿低血糖发生的危险因素,应根据危险因素及时识别和治疗新生儿低血糖,为新生儿提供及时产后护理指导,以降低新生儿低血糖发生率。
Objective To study the relevant risk factors of neonatal hypoglycemia.Methods A retrospective analysis was conducted on the clinical data of 570 newborns in neonatal pediatrics,including 190 cases in the neonatal hypoglycemia group and 380 cases in the normal blood glucose group.Logistic regression analysis was used to analyze the risk factors related to neonatal hypoglycemia.Results Single factor Logistic regression analysis showed that neonatal weight loss,premature,neonatal respiratory failure,neonatal respiratory distress,neonatal infection,the mother’s age of delivery,multipara,cesarean section,twins,pregnancy diabetes,pregnancy hypertension were the risk factors for neonatal hypoglycemia,all of which had statistical significance(all P<0.05).In multivariate Logistic regression analysis,premature(OR=2.115,95% CI:1.186-3.772)and cesarean section(OR=6.92,95% CI:4.202-11.397)were risk factors for neonatal hypoglycemia(both P<0.05).Conclusions Premature and cesarean section are risk factors for the occurrence of neonatal hypoglycemia in the local area.Timely identification and treatment of neonatal hypoglycemia based on risk factors,providing timely postpartum nursing guidance for newborns,can reduce the occurrence of neonatal hypoglycemia.
目的 探讨电子计算机断层扫描(CT)增强碘对比剂急性不良反应发生及影响因素分析。方法 选取天津市肿瘤医院空港医院2020年10月—2023年10月收治的100例行CT增强出现碘对比剂急性不良反应的患者进行回顾性分析,将其分为观察组,另选取同期在我院行CT增强检查未发生不良反应的100例患者作为对照组。分析观察组患者碘对比剂急性不良反应情况,对比两组患者临床资料及碘对比剂注射情况,以急性不良反应作为因变量(发生急性不良反应=1,未发生急性不良反应=0)纳入Logistic回归模型,分析CT增强碘对比剂急性不良反应发生的独立影响因素。结果 100例发生碘对比剂急性不良反应的患者中轻度65例(65.00%),中度34例(34.00%),重度1例(1.00%);观察组与对照组性别、年龄、体质指数(BMI)、高血压史、糖尿病史、心功能不全史、甲状腺功能亢进史、冠状动脉粥样硬化性心脏病史、碘对比剂使用史、食物过敏史对比差异无统计学意义(P>0.05),观察组与对照组哮喘史(9.00% vs 2.00%)、肾功能不全史(13.00% vs 3.00%)、碘对比剂不良反应发生史(21.00 % vs 2.00%)、花粉过敏史(12.00% vs 4.00%)、药物过敏史(26.00% vs 7.00%)及其他过敏史(10.00 % vs 2.00%),对比差异有统计学意义(χ2=4.710,P=0.030;χ2=6.790,P=0.009;χ2=17.740,P<0.001;χ2=4.350,P=0.037;χ2=13.100,P<0.001;χ2=5.670,P=0.017);观察组与对照组碘对比剂剂量对比差异无统计学意义(P>0.05),观察组与对照组碘对比剂注射速度(<3 mL/min为55.00% vs 69.00%;≥3 mL/min为45.00% vs 31.00%)、碘对比剂类型(碘克沙醇为34.00% vs 34.00%,碘佛醇为47.00% vs 30.00%,碘海醇为19.00% vs 36.00%)对比差异有统计学意义(χ2=4.160,P=0.041;χ2=9.010,P=0.011);肾功能不全史、碘对比剂不良反应发生史、药物过敏史、其他过敏史、碘对比剂注射速度为发生碘对比剂急性不良反应的影响因素(P<0.05)。结论 CT增强碘对比剂急性不良反应多以轻度为主,且以往合并肾功能不全、碘对比剂不良反应发生史、药物过敏史、其他过敏史、碘对比剂注射速度过高可能为碘对比剂不良反应发生的影响因素。
Objective To explore the occurrence and influencing factors of acute adverse reactions of iodine contrast agents in enhanced computed tomography(CT). Methods A retrospective analysis was conducted on 100 patients admitted to our hospital from October 2020 to October 2023 who experienced acute adverse reactions to iodine contrast agents during CT enhancement.They were divided into an observation group and another 100 patients who underwent CT enhancement examination in our hospital during the same period without any adverse reactions were selected as the control group.The acute adverse reactions of iodine contrast agent in the observation group of patients were analyzed,the clinical data and injection of iodine contrast agent between the two groups of patients were compared,and include acute adverse reactions as the dependent variable(occurrence of acute adverse reactions=1,absence of acute adverse reactions=0)was used in the Logistic regression model to analyze the independent influencing factors of acute adverse reactions of CT enhanced iodine contrast agent.Results Among the 100 patients who experienced acute adverse reactions to iodine contrast agents,65 were mild reactions,accounting for 65.00%,34 cases had were moderate reactions,accounting for 34.00%,and one cases had severe reactions,accounting for 1.00%.There was no significant difference between the observation group and the control group in gender,age,body mass index(BMI),history of hypertension,diabetes,heart dysfunction,hyperthyroidism,coronary heart disease,use of iodine contrast agent,and food allergy(P>0.05).The history of asthma(9.00% vs 2.00%),renal insufficiency(13.00% vs 3.00%),adverse reactions of iodine contrast(21.00 % vs 2.00%),pollen allergy(12.00% vs 4.00%),drug allergy(26.00% vs 7.00%)and other allergies(10.00 % vs 2.00%)were significantly different(χ2=4.710,P=0.030;χ2=6.790,P=0.009;χ2=17.740,P<0.001;χ2=4.350,P=0.037;χ2=13.100,P<0.001;χ2=5.670,P=0.017).There was no significant difference in the dosage of iodine contrast agent between the observation group and the control group(P>0.05).The injection rate of iodine contrast agent between the observation group and the control group(< 3 mL/min was 55.00% vs 69.00%;≥3 mL/min was 45.00% vs 31.00%),and the types of iodoxanol (iodoxanol[34.00% vs 34.00%],iodoxanol[47.00% vs 30.00%],iodohexanol[19.00% vs 36.00%]) were significantly different(χ2=4.160,P=0.041;χ2=9.010,P=0.011).History of renal insufficiency,adverse reactions to iodine contrast agents,drug allergies,other allergies,and injection speed of iodine contrast agents were independent risk factors for the occurrence of acute adverse reactions to iodine contrast agents(P<0.05).Conclusions Acute adverse reactions to iodinated contrast agents in CT enhancement are mostly mild.Previous history of renal insufficiency,history of adverse reactions to iodinated contrast agents,history of drug allergies,other allergic histories,and high injection speed of iodinated contrast agents may be influencing factors for the occurrence of adverse reactions to iodinated contrast agents.