CAJ | 학술논문

1例63岁女性行冠状动脉 CT 增强检查，静脉注射造影剂碘海醇80 ml（350 mg/ ml）。CT 检查结束留观6 min 时，患者出现手掌瘙痒、双眼结膜充血水肿、周身大汗、黑曚、恶心，呕吐少量胃内容物，随后出现唇紫、颜面水肿、四肢凉、皮肤花斑、注射部位出血。血气分析：血氧饱和度0.83，氧分压47 mmHg（1 mmHg =0.133 kPa）。距 CT 检查结束近1 h，实验室检查示血小板计数19×109/ L，凝血酶原时间（PT）18 s，凝血酶时间（TT）6 s。给予抗过敏、补充凝血因子、纠正酸中毒和电解质紊乱等治疗。距 CT 检查结束约7.5 h，患者血小板计数8×109/ L。次日，患者身体多处出现大片瘀斑，体温38.1℃，血小板计数6×109/ L。继续行对症和支持治疗，患者情况逐渐好转，第4天体温恢复正常，颜面水肿消失，瘀斑明显减轻；第6天血小板计数和凝血功能各项指标均恢复正常。
1례63세녀성행관상동맥 CT 증강검사，정맥주사조영제전해순80 ml（350 mg/ ml）。CT 검사결속류관6 min 시，환자출현수장소양、쌍안결막충혈수종、주신대한、흑몽、악심，구토소량위내용물，수후출현진자、안면수종、사지량、피부화반、주사부위출혈。혈기분석：혈양포화도0.83，양분압47 mmHg（1 mmHg =0.133 kPa）。거 CT 검사결속근1 h，실험실검사시혈소판계수19×109/ L，응혈매원시간（PT）18 s，응혈매시간（TT）6 s。급여항과민、보충응혈인자、규정산중독화전해질문란등치료。거 CT 검사결속약7.5 h，환자혈소판계수8×109/ L。차일，환자신체다처출현대편어반，체온38.1℃，혈소판계수6×109/ L。계속행대증화지지치료，환자정황축점호전，제4천체온회복정상，안면수종소실，어반명현감경；제6천혈소판계수화응혈공능각항지표균회복정상。
A 63-year-old female patient underwent coronary CT angiography and received an intravenous iohexol injection(350 mg/ ml )80 ml as the contrast agent. At the sixth minutes of observation after CT test completion,the patient developed palm itching,bilateral conjunctival congestion and edema, sweating,vertigo,nausea,and vomiting a small amount of gastric contents and then followed by lip cyanosis, facial edema,cold limbs,skin ecchymosis,and bleeding the injection site. Blood gas analysis showed an oxygen saturation of 0. 83 and an oxygen partial pressure of 47 mmHg. About an hour after CT scan,the laboratory test revealed the following levels:blood platelet count 19 × 109 / L,prothrombin time(PT)18 s, and thrombin time( TT)6 s. Treatments with anti-anaphylaxis,coagulation factor supplementation,and correction of acidosis and electrolyte disorder were given. After 7. 5 hours after CT scan,her blood platelet count was 8 ×109 / L. The next day,large pieces of skin ecchymosis appeared in many parts of her body,a body temperature reached 38. 1 ℃ and a blood platelet count was 6 × 109 / L. Symptomatic and supportive therapy was continued and her condition gradually improved. On day 4,she presented with normal temperature,disappeared facial edema,and relief of skin ecchymosis. On day 6,her level of blood platelet and all the values of coagulation functions returned to normal.