目的 对比磁敏感加权成像（SWI）、磁共振成像（MRI）、第3代双源电子计算机断层扫描（CT）三种方式在急性缺血性脑卒中（AIS）患者血管内治疗后诊断出血灶以及碘对比剂外渗中的临床价值。方法 选取2022年1月—2023年2月在新乡医学院第一附属医院接受血管内治疗的80例AIS患者作为研究对象,所有患者均接受MRI、SWI、第3代双源CT检查,经综合分析后确定诊断结果,对比三种检查方法对治疗后早期出血灶的鉴别效能,同时以治疗72 h后的常规CT结果作为诊断金标准,评价三种检查方法诊断早期出血灶与碘对比剂外渗的效能。结果 MRI的阳性预测价值为90.32%、阴性预测价值为88.00%,SWI的阳性预测价值为93.55%、阴性预测价值为92.00%,第3代双源CT的阳性预测价值为93.75%、阴性预测价值为95.83%,其中第3代双源CT与金标准的一致性更高（Kappa=0.891）。与治疗72 h后的常规CT结果对比,MRI的曲线下面积（AUC）为0.907,诊断灵敏度为90.32%、特异度为88.00%、准确度为89.29%;SWI的AUC为0.937,诊断灵敏度为93.55%、特异度为92.00%、准确度为92.86%;第3代双源CT的AUC为0.971,诊断灵敏度为96.77%、特异度为92.00%、准确度为94.64%,第3代双源CT的诊断效能最高。结论 AIS血管内治疗后,采用SWI、MRI、第3代双源CT三种检查方式均能有效区分出血灶与碘对比剂外渗情况,且临床诊断价值较好。

目的 探讨品管圈(Quality Control Circle, QCC)活动对降低造影剂外渗的效果观察。方法 根据QCC的方法和步骤,成立QCC小组,通过比较和分析QCC活动实施前后外渗率的变化,找出导致CT增强扫描前接受高压静脉造影剂注射外渗的主要原因,提出针对性的改进措施并分析其效果。结果 QCC活动实施前外渗率达0.17%,而实施后外渗率为0.07%,差异有统计学意义(P<0.05)。结论 开展QCC活动可降低CT增强扫描前造影剂外渗发生率,值得临床推广应用。

Objective To investigate the effect of quality control circle (QCC)activity on reducing contrast agent extravasation. Methods According to the steps and methods of the quality control circle, a QCC group was set up to compare and analyze the data before and after the implementation of QCC activities to find out the main reason for the extravasation of high-pressure intravenous contrast agent injection before CT enhanced scanning, and put forward targeted improvement measures to analyze its effect. Results The extravasation rate before QCC activity was 0.17%, and the extravasation rate after implementation was 0.07%, the difference was statistically significant (P <0.05). Conclusion Carrying out QCC activities may reduce the incidence of contrast agent extravasation before CT enhanced scanning, which is worthy of clinical application.

目的 通过开展QC活动降低PICU患儿补液外渗发生率。减轻患儿不适,强化护士主动服务的意识,提高护理质量,提升管理效果。方法 成立QC小组,按照PDCA循环法,调查PICU患儿补液外渗情况及存在问题,制定对策,组织实施,定期对效果进行评价、总结。结果 外渗发生率由活动前的15.48%下降至活动后的10.44%,严重外渗发生率由活动前的2.38%下降至活动后的0.55%,P<0.05,差异有统计学意义。结论 QC活动有效降低PICU患者补液外渗发生率。

Objective To conduct QC activities to reduce the incidence of fluid extravasation in PICU patients. Relieve discomfort in PICU patients,and strengthen the awareness of nurses active service,improve quality of care and management effectiveness. Methods Establishing QC circle,applying the method of PDCA cycle,investigating fluid extravasation in PICU patients,analyzing the main reasons for fluid extravasation,developing countermeasures,Implementing strategies,summarizing and evaluating the effects regularly.Comparing the incidence of fluid extravasation in PICU patients before and after the activity. Results After the activity,the incidence of fluid extravasation decreased from 15.48% to10.44%,the incidence of severe fluid extravasation decreased from 2.38% to 0.55%,P<0.05,the difference was statistically significant. Conclusion The QC activity effectivelycan reduce the incidence of severe fluid extravasation in PICU patients.