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題 名 | 使用二氧化碳血管造影於臨床介入手術運用=Application of Carbon Dioxide Injector Digital Angiography for Interventional Surgery |
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作 者 | 江武陽; 吳重寬; 陳彥仰; 高鴻儒; 吳典育; 鐘情華; 邵群傑; 王秋皓; 林佳勳; | 書刊名 | 內科學誌 |
卷 期 | 29:6 2018.12[民107.12] |
頁 次 | 頁408-416 |
分類號 | 415.21 |
關鍵詞 | 含碘對比劑; 數位血管減像攝影; 二氧化碳注射器; Iodine contrast medium; ICM; Digital subtraction angiography; DSA; Carbon dioxide injector; |
語 文 | 中文(Chinese) |
中文摘要 | 二氧化碳CO2是存在於大自然與人體內的氣體,CO2無毒性、具高溶解度、低黏性、無過敏反應且不破壞殘餘腎功能等特質,並可立即隨呼吸排出使用劑量無限制,是替代含碘對比劑(iodine contrast medium, ICM)用於血管造影的首選。尤其近年來數位血管減像攝影(digital subtraction angiography, DSA)及影像增強技術的進步,使用CO2當對比劑也更具有臨床實用價值,特別是腎功能不全或對比劑過敏的患者,需要進行複雜的動靜脈血管腔內治療,CO2就是最佳的造影劑。本院自2017 年起使用全台第一台二氧化碳注射器,它能夠提供定量體積及穩定且持續的壓力,不會混入一般空氣,避免氣體栓塞的發生。在這兩年來我們使用CO2 DSA,進行腹主動脈人工血管支架修復腹主動脈瘤、周邊下肢動脈血管阻塞介入治療、血液透析瘻管早期促成熟及功能不良等介入治療,不僅順利完成治療且在影像上品質也不亞於傳統含碘對比劑。 |
英文摘要 | Carbon dioxide (CO2), a colorless and odorless gas, which has non-toxicity, high solubility, low viscosity, and is non-allergenic and harmless to kidney, exists in nature and in human body. CO2 dissolves in the blood and is expelled from the lungs. There is no dose limitation in its clinical usage. In recent years, advances in digital subtraction angiography (DSA) and image enhancement technology have enabled CO2 to be used as a contrast medium for patients with advanced renal disease or contrast medium allergy but requiring complicated endovascular treatment. In such cases, CO2 will be the best alternative contrast medium. We widely apply the CO2 DSA since February 2017 and employed the first CO2 injector in Taiwan. The auto injector provided fixed volume and constant pressure for CO2 transport without the chance of mixing air, and thus greatly reduced the risk of air embolism. For the last two years, we have used CO2 DSA during intervention therapy for 61 cases including endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm, endovascular intervention for peripheral arterial occlusive disease and dysfunctional hemodialysis arteriovenous fistula or graft. We successfully completed the treatment in these patients without or with reduced iodine contrast medium. The quality of images is comparable to traditional iodine contrast medium. |
本系統中英文摘要資訊取自各篇刊載內容。