Effect of chain process management on improving iodinated contrast extravasation within the CT examination for acute stroke green channel

doi:10.3877/cma.j.issn.1673-9248.2025.06.004

Abstract

Abstract:

Objective

To investigate the effect of chain process management on improving iodine contrast medium extravasation (CME) in multi-mode CT examination for acute stroke via the green channel.

Methods

A total of 864 patients with suspected stroke who underwent green channel multi-mode CT in the First Affiliated Hospital of Naval Medical University from June to November 2023 were enrolled. Based on the nursing management process implementation phase, 404 patients from June to August were assigned to the control group (routine nursing), and 460 from September to November to the treatment group (chain process management). CME incidence, grading, and time from admission to intravenous access establishment were compared using Chi-square test, Fisher's exact test, and one-way ANOVA, respectively.

Results

The CME incidence was significantly lower in the treatment group than that in the control group [0.87% (4/460) vs 4.46% (18/404), χ²=11.146, P=0.001]. The treatment group had 3 cases of mild and 1 case of moderate iodine CME, and the control group had 3 cases of mild and 15 cases of moderate iodine CME. The grade of iodine CME in treatment groups was significantly lower than that in control group (P=0.046). The time from admission to venous access did not differ significantly between groups [(306.52±141.95) s in control vs (300.04±125.58) s in treatment (t=0.707，P=0.480)].

Conclusion

Chain process management effectively reduces the incidence and severity of CME in acute stroke patients undergoing multi-mode CT via the green channel, without delaying venous access establishment.

Key words: Acute stroke, Multi-mode CT examination, Iodine contrast agent, Extravasation, Chain process management, Complication

Xiaojie Shan, Huanhuan Hu, Lei Zhang, Jiakang Yang, Jianmin Liu, Lifen Gan, Li Xu, Hongyue Li, Dongmei Li. Effect of chain process management on improving iodinated contrast extravasation within the CT examination for acute stroke green channel[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2025, 19(06): 477-482.

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URL: https://zhnxgbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1673-9248.2025.06.004

https://zhnxgbzz.cma-cmc.com.cn/EN/Y2025/V19/I06/477

Figures/Tables 2

一般资料	对照组（n=404）	试验组（n=460）	统计值	P值
性别[例（%）]			χ²=0.381	0.537
男	258（63.86）	303（65.87）
女	146（36.14）	157（34.13）
年龄（岁， $x ¯$ ±s）	65.71±13.61	65.49±12.97	t=0.239	0.811
既往史[例（%）]
糖尿病史	155（38.37）	178（38.70）	χ²=0.010	0.921
高血脂史	115（28.47）	143（31.09）	χ²=0.706	0.401
高血压史	297（73.51）	339（73.70）	χ²=0.004	0.952
心功能不全史	272（67.33）	307（66.74）	χ²=0.034	0.855
碘对比剂外渗史	29（7.18）	23（5.00）	χ²=1.804	0.179
困难静脉通路史	169（41.83）	215（46.74）	χ²=2.098	0.147
长期口服抗凝药史	111（27.48）	131（28.48）	χ²=0.107	0.743
恶性肿瘤史	34（8.42）	30（6.52）	χ²=1.125	0.289

一般资料	对照组（n=404）	试验组（n=460）	统计值	P值
性别[例（%）]			χ²=0.381	0.537
男	258（63.86）	303（65.87）
女	146（36.14）	157（34.13）
年龄（岁， $x ¯$ ±s）	65.71±13.61	65.49±12.97	t=0.239	0.811
既往史[例（%）]
糖尿病史	155（38.37）	178（38.70）	χ²=0.010	0.921
高血脂史	115（28.47）	143（31.09）	χ²=0.706	0.401
高血压史	297（73.51）	339（73.70）	χ²=0.004	0.952
心功能不全史	272（67.33）	307（66.74）	χ²=0.034	0.855
碘对比剂外渗史	29（7.18）	23（5.00）	χ²=1.804	0.179
困难静脉通路史	169（41.83）	215（46.74）	χ²=2.098	0.147
长期口服抗凝药史	111（27.48）	131（28.48）	χ²=0.107	0.743
恶性肿瘤史	34（8.42）	30（6.52）	χ²=1.125	0.289

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