河南省含碘对比剂外渗管理现状及护士认知水平的调查研究

doi:10.3761/j.issn.0254-1769.2025.11.011

摘要/Abstract

摘要：

目的调查河南省含碘对比剂（iodinated contrast media，ICM）外渗管理现状、护士对相关知识的认知水平，并分析认知水平的影响因素，为优化管理策略提供依据。方法自行设计调查问卷，采用便利抽样法，于2024年12月—2025年1月对河南省16个省辖市55所三级医院放射科的护理管理者及护士进行调查，采用多元线性回归分析探究护士对相关知识认知水平的影响因素。结果分别有55名护理管理者、64名护士参与调查，有效问卷回收率为100%。调查结果显示，仅5.45%的放射科使用耐高压型中心静脉通路，32.73%使用血管可视化技术；在设定ICM高压注射速度时，仅54.55%的放射科要求评估静脉通路类型及型号；仅9.09%的放射科在ICM外渗后要求观察2~4 h；仅50.91%的放射科建立ICM使用信息系统。护士相关知识得分为（90.00±17.59）分，放射科工作年限、职称是其影响因素（P<0.05）。结论河南省放射科ICM外渗管理措施有待进一步完善，护理管理者应优化管理策略，完善相关培训体系，不断提升护士的认知水平及实践能力。

关键词: 含碘对比剂, 外渗, 高压注射, 横断面调查, 护理

Abstract:

Objective To investigate the status of management of iodinated contrast media（ICM） extravasation in Henan Province，as well as nurses’ knowledge and influencing factors，in order to provide a basis for optimizing management strategies. Methods A self-designed questionnaire was applied，employing convenience sampling，to survey nursing administrators and nurses in the radiology departments of 55 tertiary hospitals across 16 regions of Henan Province，from December 2024 to January 2025. Multiple linear regression analysis was conducted to explore the factors influencing nurses’ knowledge. Results A total of 55 nursing administrators and 64 nurses participated，with a valid questionnaire response rate of 100%. The survey results reveal that only 5.45% of radiology departments utilized high-pressure central venous catheters，and 32.73% employed vascular visualization techniques. When setting the high-pressure injection speed for ICM，only 54.55% of radiology departments required an assessment of the type and model of intravenous access. Additionally，only 9.09% of radiology departments mandated an observation for 2 to 4 hours following ICM extravasation. Furthermore，only 50.91% of radiology departments had established an information system for ICM use. The nurses’ knowledge score regarding the prevention and management of ICM extravasation was（90.00±17.59），influenced by years of experience in radiology and professional titles（P<0.05）. Conclusion The prevention and management measures for ICM in radiology departments in Henan Province need further improvement. Nursing administrators should optimize management strategies，improve relevant training systems，and continuously enhance nurses’ knowledge and practical abilities.

Key words: Iodinated Contrast Media, Extravasation, High-Pressure Injection, Cross-Sectional Study, Nursing Care

宋圆圆, 王宇, 蒿若楠, 董方方, 黄霖霖, 杨巧芳, 贾晓辉, 白姗. 河南省含碘对比剂外渗管理现状及护士认知水平的调查研究[J]. 中华护理杂志, 2025, 60(11): 1351-1358.

SONG Yuanyuan, WANG Yu, HAO Ruonan, DONG Fangfang, HUANG Linlin, YANG Qiaofang, JIA Xiaohui, BAI Shan. Investigation on the management and nurses’ cognitive level of iodinated contrast media extravasation in Henan Province[J]. Chinese Journal of Nursing, 2025, 60(11): 1351-1358.

图/表 6

表1 河南省放射科静脉通路风险管理现状（n=55）

Table 1 Risk management status of intravenous access in radiology departments of Henan Province（n=55）

表2 河南省放射科含碘对比剂高压注射风险管理现状（n=55）

Table 2 Risk management status of high-pressure ICM injection in radiology departments of Henan Province（n=55）

表3 河南省放射科含碘对比剂注射后及外渗后的处理措施（n=55）

Table 3 Handling measures for post-injection and extravasation of ICM in radiology departments of Henan Province（n=55）

表4 河南省放射科含碘对比剂外渗风险管理制度及培训现状（n=55）

Table 4 Risk management system and current training status for ICM extravasation in radiology departments of Henan Province（n=55）

表5 河南省放射科护士的一般资料与对含碘对比剂外渗预防及处理相关知识认知水平的单因素分析结果（n=64）

Table 5 Univariate analysis results of general data and knowledge of radiology nurses on prevention and handling of ICM extravasation in Henan Province（n=64）

表6 河南省放射科护士对含碘对比剂外渗预防及处理相关知识认知水平的多元线性回归分析结果（n=64）

Table 6 Multiple linear regression analysis of knowledge of radiology nurses on prevention and handling of ICM extravasation in Henan Province（n=64）

参考文献 16

[1]	Khan A, Bajaj S, Khunte M, et al. Con-trast agent administration as a source of liability:a legal database analysis[J]. Radiology, 2023, 308(3):e230802.
[2]	中华护理学会内科专业委员会. 含碘对比剂静脉外渗护理管理实践指南[J]. 中华护理杂志, 2021, 56(7):1008. DOI
	Internal Medicine Nursing Committee of Chinese Nursing Association. Clinical practice guideline for nursing manage-ment of iodinated contrast media extra-vasation[J]. Chin J Nurs, 2021, 56(7):1008. DOI
[3]	中华医学会影像技术分会医学影像护理专委会. 影像增强检查静脉输注工具规范应用专家共识[J]. 中国医疗设备, 2021, 36(3):1-5.
	Professional Committee on Radiological Nursing Care,Radio-logy Branch of Chinese Medical Association. Expert consensus on standardized application of intravenous infusion tools for enhanced imaging[J]. China Med Devices, 2021, 36(3):1-5.
[4]	彭燕丽, 王一凡, 冯舒丽, 等. 标准化耐高压输液港护理流程在恶性肿瘤患者CT增强检查对比剂注射中的效果评价[J]. 中国实用护理杂志, 2024, 40(22):1705-1709.
	Peng YL, Wang YF, Feng SL, et al. Evaluation of the effect of contrast medium injection in CT enhanced examination of malignant tumor patients with standardized nursing procedure of totally implantable venous power port[J]. Chin J Pract Nurs, 2024, 40(22):1705-1709.
[5]	Wortley V, Almerol LA. Misplacement of piccs following power-injected CT contrast media[J]. Br J Nurs, 2020, 29(19):S4-S10.
[6]	向静, 陈博春, 赖声晓, 等. 迷你中线导管的临床应用研究进展[J]. 中国医学装备, 2024, 21(11):157-162.
	Xiang J, Chen BC, Lai SX, et al. Clinical application and re-search progress of mini-midline catheters[J]. China Med Equip, 2024, 21(11):157-162.
[7]	Watts-Pajaro F, Uribe-Buritica FL. Alternative vascular device for high-flow computed tomography angiography:ultrasound-guided long peripheral catheter(4 Fr × 10 cm)[J]. J Vasc Access, 2021, 22(2):288-291.
[8]	Gorski LA, Hadaway L, Hagle ME, et al. Infusion therapy stan-dards of practice,8th edition[J]. J Infus Nurs, 2021, 44(Suppl 1):S1-S224.
[9]	潘红红, 陈伟彬. 高浓度对比剂联合“三低” 方案行颈动脉CTA可行性分析[J]. 华北理工大学学报(医学版), 2023, 25(2):90-95.
	Pan HH, Chen WB. Feasibility analysis of high concentration contrast agent combined with“three low” scheme for carotid artery CTA[J]. J N China Univ Sci Technol Health Sci Ed, 2023, 25(2):90-95.
[10]	Roditi G, Khan N, van der Molen AJ, et al. Intravenous con-trast medium extravasation:systematic review and updated ESUR contrast media safety committee guidelines[J]. Eur Radiol, 2022, 32(5):3056-3066. DOI PMID
[11]	Diop B, Soh GT, Nde AFT, et al. Hand compartment syndrome secondary to contrast media extravasation:a case report[J]. Int J Surg Case Rep, 2022, 98:107595.
[12]	国家卫生健康委办公厅. 国家卫生健康委办公厅关于印发急诊医学等6个专业医疗质量控制指标(2024年版)的通知[EB/OL].(2024-04-30)[2024-10-13]. https://www.gov.cn/zhengce/zhengceku/202405/content_6951260.htm.
	General Office of National Health Commission. Notice of the Office of the National Health Commission on the issuance of medical quality control indicators for six specialties including emergency medicine(2024 edition)[EB/OL].(2024-04-30)[2024-10-13]. https://www.gov.cn/zhengce/zhengceku/202405/content_6951260.htm.
[13]	董方方, 王蕾, 高伟, 等. 1926所医院静脉治疗质量管理现状的调查研究[J]. 中华护理杂志, 2024, 59(20):2447-2455. DOI
	Dong FF, Wang L, Gao W, et al. Investigation on the quality management of intravenous therapy in 1 926 hospitals[J]. Chin J Nurs, 2024, 59(20):2447-2455. DOI
[14]	李谷维, 骆金铠, 张杰, 等. 静脉输液质量监测闭环追踪系统的构建及应用[J]. 中华护理杂志, 2023, 58(23):2829-2834. DOI
	Li GW, Luo JK, Zhang J, et al. Application of a closed-loop tracking system in the quality monitoring program for intra-venous infusions[J]. Chin J Nurs, 2023, 58(23):2829-2834.
[15]	王雨晴, 叶茹明, 方继红, 等. 儿科护士预防和处理静脉外渗/渗出知信行问卷调查[J]. 中国循证儿科杂志, 2022, 17(6):463-468.
	Wang YQ, Ye RM, Fang JH, et al. Questionnaire survey on knowledge,attitude and behavior of pediatric nurses on pre-vention and treatment of intravenous infusion extravasation[J]. Chin J Evid Based Pediatr, 2022, 17(6):463-468.
[16]	崔培荣, 周莹霞, 张明霞, 等. 护士胰岛素注射知信行临床实践与指南差距的调查研究[J]. 中华护理杂志, 2023, 58(10):1178-1185. DOI
	Cui PR, Zhou YX, Zhang MX, et al. Investigation and research of the gap between clinical practice and guidelines of nurse knowledge,attitude and practice on insulin injection[J]. Chin J Nurs, 2023, 58(10):1178-1185.