靜脈注射含碘對比劑之不良反應: 一家醫學中心之經驗

Background: Adverse reactions to intravenous injection of iodinated contrast media are commonly encountered in routine radiological practice. The purpose of this study was to investigate the adverse reactions to intravenous injection of iodinated contrast media. The correlation between contrast media type and the severity and risk of an adverse reaction was analyzed.
Materials and Methods: Cases of intravenous contrast media induced reactions during intravenous pyelography (IVP) and computed tomography (CT) in a medical center over an 18 month period were collected. The type, severity and risk of adverse reactions were analyzed.
Results: Over the study period, intravenous injection of iodinated contrast media took place in 28364 patients, with adverse reactions occurring in 495. The risk of an adverse reactions was around 1.745%. The risk of an adverse reaction to ionic contrast media was 2.035% (467/20260)and to non-ionic contrast media was 0.346% (28/8076).The data show that the risk of an adverse reactions to non-ionic contrast media is significantly lower than for ionic contrast media (p＜0.001). Cutaneous symptoms such as urticaria are the most commonly seen reactions, followed by nausea and vomiting. In the series, there were six cases (0.021%) of shock requiring cardiopulmonary resuscitation (CPR), but no fatalities.
Conclusions: This study highlights the most common symptoms seen in adverse reactions to intravenous contrast media, aiding early diagnosis. Appropriate management and the use of non-ionic contrast can minimize the risk of severe complications.