| Objective:To explore the feasibility of low-flow iodine contrast agent injection protocol with low injection rate and dosage of iodine contrast agent in the triple-rule-out CT angiography of chest pain patients,and minimise the risk of untoward effect of iodine contrast agent and ensure the security of examination for patients on the premise of meeting the conditions of clinical imaging diagnosis.In addition,by analyzing the current situation of health knowledge demand of patients with chest pain enhancement,it provides basis and reference for the development of health education model and more systematic and standardized nursing plan of patients with chest pain enhancement examination in the future,reduces psychological anxiety caused by lack of knowledge of patients,increases the degree of nursing-patient cooperation,and improves patient satisfaction.Methods:30 cases who underwent triple-rule-out examination from January 2020 to April2021 were retrospectively collected as the control group(group A).120 patients who underwent CT enhancement examination for chest pain from May 2021 to February 2022 were prospectively collected as the investigation object group C,and the questionnaire analysis of health education knowledge demand for chest pain enhancement examination was conducted.Sixty patients in group C who needed triple chest pain examination from May 2021 to January 2022 were selected as experimental group(group B),and then divided into group B1 and group B2 according to random number table method,with 30 patients in each group.The control group was injected with 75 ml iodine contrast agent with a rate of 5ml/s,and the experimental groups(B1 and B2)were injected with 60 ml iodine contrast agent with a rate of 4.5ml/s or 3.5ml/s.Compare the image quality(subjective and objective)of the patient’s blood vessels at different levels and the overall effective radiation dose to complete an examination was recorded.statistical software SPSS22.0 was used to compare the collected data,including one-way ANOVA,two independent samples t-test,LSD-t test,non-parametric test and multiple linear regression analysis.P<0.05 was considered statistically significant.Results:(1)The application effect of low-flow iodine contrast agent injection protocol:(1)The differences in image quality of pulmonary artery and coronary artery between group A and group B1 were not significant(P>0.05),the CT number and contrast to noise ratio values of aortic images in group A were higher than those in group B1,and the differences bears significance in statistics(P<0.05).(2)The CT number and CNR values of pulmonary artery and coronary artery in group A were higher than those in group B2,and the differences bears significance in statistics(P<0.05),The differences in image quality of aorta between group A and group B2 were not significant(P>0.05).(3)The CT number and CNR values of pulmonary artery and coronary artery in group B2 were lower than those in group B1,and the differences bears significance in statistics(P< 0.05),the CT number and contrast to noise ratio values of aortic images in group B1 were lower than those in group B2,and the differences bears significance in statistics(P<0.05).(4)The differences in subjective scores of pulmonary artery,aorta and coronary artery of the three groups were not significant(P>0.05).(5)The differences in effective radiation dose of the three groups were not significant(P>0.05).(6)The image quality of triple-rule-out examination of the three groups can meet the requirements of clinical diagnosis.(2)The survey of health education knowledge demand in the enhanced CT examination of chest pain patients:(1)The 120 cases had the highest demand for health education knowledge in three aspects: "process of examination","matters needing attention after examination" and "possible adverse reactions of iodine contrast agent ".(2)There is a significant correlation between education level and patients’ knowledge demand,the higher the education level,the higher the demand for health education knowledge.(3)At present,the main source of health education knowledge of patients is nurses in the imaging department.The most desired health education method of patients is still mainly guided by medical staff,and they also hope to obtain health education related knowledge through official accounts,videos and brochures.Conclusion:(1)The low-flow iodine contrast agent injection scheme with low injection rate and dosage of iodine contrast media can satisfy the requirements of clinical diagnostic of triple-rule-out examination of chest pain and provide high-quality image quality.It can effectively reduce the dosage of iodine contrast agent while reducing the injection rate,and may reduce the risk of adverse events of iodine contrast agent,which provide a more optimized injection scheme of contrast agent for imaging examination and has certain clinical application value.(2)Patients with chest pain have a high demand for health education knowledge during enhanced examination,mainly in examination and medication related knowledge,but knowledge of hydration is neglected,so it is necessary to further improve the health education program and strengthen cooperation with nurses in clinical departments.To provide basis for developing health education and nursing program for chest pain patients. |
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