Introduction of pulmonary angiography, what is the role?

Directory 1 pinyin 2 English reference 3 operation name 4 indications for pulmonary angiography 5 contraindications for pulmonary angiography 6 preparation 7 methods 8 precautions 1 pinyin fè i dê fèi dòng mài zào yǐng o y ê ng

English reference art of pulmonary artery

Pulmonary arteriography

3 name of operation pulmonary angiography

Indications Pulmonary arteriography is suitable for:

1. Massive hemoptysis caused by pulmonary artery disease.

2. Pulmonary aneurysm.

3. Congenital pulmonary arteriovenous malformation.

4. Pulmonary arteriovenous fistula.

5. Pulmonary embolism.

Contraindications 1. Contrast agent and anesthetic allergy.

2. Serious systemic diseases such as severe heart, liver and renal insufficiency.

3. Extreme weakness and severe coagulation dysfunction.

4. The active period of acute infectious diseases or rheumatism.

5. Acute heart disease, such as acute myocardial infarction and arrhythmia.

6 ready 1. Patient preparation

(1) Explain the imaging purpose, possible complications and accidents to patients and their families, and sign an imaging agreement.

(2) Ask about medical history and necessary imaging examinations, such as chest X-ray, CT and fiberoptic bronchoscopy.

(3) Check the heart, liver and kidney functions, as well as blood routine and bleeding and coagulation time.

(4) Iodine and anesthetic should be treated according to the requirements of Pharmacopoeia.

(5) Eating and drinking were forbidden 4 hours before operation, and diazepam 10mg was injected into muscle 0.5h hour before operation.

(6) Routine skin preparation at the puncture site.

(7) When necessary, measure arterial oxygen partial pressure or oxygen saturation.

(8) Establish venous access to facilitate intraoperative medication and rescue.

2. Equipment preparation

(1) Cardiovascular X-ray machine and its accessories.

(2) Disinfection kit for imaging surgical instruments.

(3) Puncture and intubation instruments, such as puncture needle, catheter sheath, pigtail catheter, guide wire, etc.

(4) Pressure injector, injector and connecting pipe.

(5) bronchoscope, tracheal intubation instruments, aspirator and artificial respirator, etc.

(6) Cardiopulmonary resuscitation instruments such as ECG monitors and defibrillators.

3. Drug preparation

(1) contrast agent: organic iodine water preparation (ionic or nonionic with corresponding concentration of 40% ~ 76%).

(2) Anesthetics, anticoagulants and various rescue drugs.

Method 1. Puncture femoral artery under local anesthesia, introduce pigtail catheter, and put the catheter tip into pulmonary artery trunk through right atrium and right ventricle.

2. Injection parameters: the dose of contrast agent is 20 ~ 40ml/ time, and the injection flow rate is13 ~16ml/s. ..

3. The photo * * * is positive lateral position, with oblique position if necessary.

4. The imaging procedure is 15 ~ 50 frames per second, and the injection delay is 0.5s Each angiography should include images of arterial phase, microvascular phase and venous phase.

5. Pull out the catheter after radiography, apply local pressure 10 ~ 15 min, and then apply pressure to bandage.

6. Photographers should carefully fill in the relevant items and technical parameters of the inspection application form and sign it.

8 precautions 1. Master indications and contraindications.

2. Be prepared before operation.

3. For pulmonary arteriovenous malformation with high blood viscosity, heparinization should be paid attention to during catheter operation to prevent thrombosis.

4. Observe the patient's reaction closely and prepare for first aid. If there is arrhythmia during operation, the catheter should be removed immediately.

5. Stay in bed for 24 hours after operation, inject antibiotics intravenously, and observe for a certain period of time, paying attention to the possible angiographic complications of patients.

6. Prevention and treatment of the following complications

(1) Complications of puncture and intubation: temporary arterial spasm, local hematoma, pseudoaneurysm and arteriovenous fistula, intra-arterial rupture of catheter, intimal detachment, atherosclerotic plaque shedding, vascular rupture, thrombosis and air embolism.

(2) Complications of contrast agent: shock, convulsion, spinal cord transection injury, epilepsy and brain edema, laryngeal edema, laryngeal or/and bronchospasm, pulmonary edema, acute renal failure, etc.