急性胸痛病人CT检查中护理预警评估元素的研究  

Study on evaluation elements of nursing early warning system in CT examination of patients with acute chest pain

作　　者：华莉 张记清 王凤仙 张月英 HUA Li;ZHANG Jiqing;WANG Fengxian;ZHANG Yueying(School of Nursing,Shanxi Medical University,Shanxi 030001 China)

机构地区：[1]山西医科大学护理学院,山西030001 [2]山西医科大学第二医院

出　　处：《护理研究》2020年第16期2837-2841,共5页Chinese Nursing Research

基　　金：山西省重点研发计划项目(社会发展方面),编号:201903D321192。

摘　　要：[目的]探讨个体化因素对急性胸痛病人CT检查图像质量的影响,为检查前护理预警评估指标的制定提供循证依据。[方法]选取2018年1月—2019年2月在山西省某三级甲等综合医院行胸痛三联检查的75例病人为研究对象,分析病人个体化因素与各部位血管的图像质量评分之间的关系。[结果]所有病人各血管节段图像质量均满足诊断要求;Logistic回归结果显示:体质指数(BMI)、呼吸状态是肺动脉图像质量的主要影响因素(P<0.05);BMI、心功能分级是冠状动脉图像质量的主要影响因素(P<0.05);BMI、扫描时心率是主动脉图像质量的主要影响因素(P<0.05)。[结论]应用Revolution CT为病人进行胸痛三联检查时,可以实现低碘对比剂用量和低辐射剂量的"双低"模式,但检查中BMI、呼吸状态、心功能分级和扫描时心率等可能影响图像质量。护士应在检查前详细评估病人的个体化因素,并给予相应的护理干预,提升病人在检查中的配合度和图像质量,利于临床诊断。Objective:To probe into effects of individual factors on image quality of CT examination in patients with acute chest pain,and to provide the evidence-based basis for the establishment of evaluation indicators of nursing early warning before the examination.Methods:Seventy-five patients,who underwent triple rule out(TRO)examination of chest pain in a tertiary grade A general hospital in Shanxi province from January 2018 to February 2019,were enrolled as subjects. The relationships between individualized factors of patients and image quality scores of blood vessels at different sites were analyzed.Results:The image quality of different vascular segemnts among patients,which met the diagnostic requirements. Multiple logisitic regression results showed that body mass index(BMI)and respiratory status were main influencing factors of image quality of pulmonary artery(P<0. 05). BMI and cardiac function grading were main influencing factors of image quality of coronary artery(P<0. 05). BMI and heart rate during scanning were main influencing factors of image quality of aorta(P<0. 05).Conclusions:TRO examination of chest pain via Revolution CT,could achieve a "double low" pattern charactered with low iodine contrast dose and low radiation dose. But in the process of CT checking,BMI,respiratory status,heart function grading and heart rate during scanning,which all might affect image quality. Before the CT examination,radiology nurses should evaluate the individual factors of patients in detail and take corresponding nursing intervention with a view to improving patient’ s cooperation and CT image quality and being helpful to clinical diagnosis.

关 键 词：胸痛三联征 碘对比剂 影响因素 图像质量 诊断 体质指数 心功能分级 心率 

分 类 号：R473.5[医药卫生—护理学]