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Objective@#To investigate the relationship between radiofrequency ablation immediately after enhanced CT scanning and the occurrence of contrast agent spillover and postoperative severe bleeding, and analyze the risk factors for hepatocellular carcinoma (HCC).@*Methods@#A retrospective analysis of 199 patients with hepatocellular carcinoma who underwent radiofrequency ablation of liver cancer in our hospital from January 2016 to January 2017 was reviewed. A total of 232 cases were treated with ablation. The agent spillovers were divided into two groups, one for the contrast agent spill group and the other for the non-contrast agent spill group. Its basic clinical data, laboratory data related to the risk of bleeding, and imaging data were analyzed to explore their clinical treatment effects and the risk factors for their occurrence. According to different data, t-test, χ2 test or logistic regression test was used for statistical analysis.@*Results@#In 199 patients, a total of 232 cases were treated with ablation, including 138 males and 61 females. The average age was (57.56 ± 12.09) years and the average diameter of lesions was (3.42 ± 2.30) cm. A total of 30 cases (12.93%) of contrast agent spillover occurred immediately after the ablation of CT scanning needle. There were no severe bleeding and no special clinical intervention after the operation. The other 202 cases were non- contrast agent spill group, but 2 cases had severe bleeding and had corresponding clinical interventions. Univariate analysis showed that there were statistically significant differences in thoracentesis (P = 0.019), complications of cirrhosis (P < 0.001), and histological types of liver cancer (P = 0.013), and other clinical data [age, lesion size]. There were no significant differences in Child-Pugh classification, preoperative hemoglobin (HGB), platelet count, prothrombin time, APTT, international standardized ratio, number of puncture needles, and puncture length. There was also no significant difference in postoperative HGB (P = 0.160), preoperative-postoperative HGB change (P = 0.999), and length of hospital stay (P = 0.730) between the two groups. Logistic regression analysis showed that with cirrhosis (OR = 5.59, P < 0.001), transthoracic puncture (OR = 2.67, P = 0.021) may be a risk factor for contrast agent spillover after CT-enhanced CT scan in patients with hepatocellular carcinoma.@*Conclusion@#Contrast agent spillover is not uncommon in the evaluation of curative effect of CT immediately after ablation (12.93%). It is not predictive for the occurrence of postoperative severe bleeding and does not require excessive clinical intervention. Liver cirrhosis and transthoracic cavity puncture may be the risk factors for its occurrence. The risk of severe postoperative bleeding should not be ignored for patients who have no contrast agent spills after surgery.
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Objective Through analyzing the causes of iodine contrast agent extravasation,nursing managers develop effective solutions timely and take appropriate precautionary measures to ensure the safety of patients effectively.Methods 600 patients undergoing CT contrast enhanced scan were selected,300 patients from May 2009 to April 2010 were set as the control group and were given routine nursing care,300 patients from May 2010 to April 2011 were set as the study group and they adopted effective preventive measures.The incidence of adverse events after injection of iodine contrast agent between the two groups was compared.Results The incidence of iodine contrast medium extravasation in the study group was significantly reduced to 2％ after taking a series of preventive measures,which was lower than 10％ of the control group.Conclusions Taking a series of preventive measures can reduce the incidence of adverse events of iodine contrast agent extravasation,ensure the safety of patients,decrease the frequency of nursing complaints and nursing deficiencies,as well as improve the quality of nursing service.