| Objective:To explore the effect of individualized contrast media injection protocol based on iodine delivery rate(IDR)on image quality in Revolution CT coronary angiography(CCTA).To establish a mind mapping health education program and evaluate its application effect in CCTA examination of elderly patients.The purpose of this study is to provide ideas for the rational use of iodine contrast agent in clinical CCTA examination and to provide an effective nursing intervention program for the smooth implementation of the examination.Methods:PartⅠ:To analyze the feasibility of individualized injection protocol based on iodine delivery rate in CCTA examination180 cases of subjects who underwent CCTA examination from December 2019 to July2020 were randomly divided into group A(n=90)and group B(n=90),and the injection time of both groups was 12s.Group A was the control group and was injected with a fixed dosage of 60ml contrast media at 5.0ml/s.Group B was the experimental group,and the iodine delivery rate was selected according to the body weight of patients(≤60kg-1.12g I/s,60～70kg-1.26g I/s,≥70kg-1.40g I/s),while the flow velocity and dose of contrast media were calculated respectively according to the formula.The differences of objective indicators and subjective assecement between groups A and B were compared.And the effect of body weight on vascular enhancement in different injection schemes was analyzed.PartⅡ:To evaluate the effect of mind mapping health education on coronary CT angiography in elderly patientsThe convenience sampling method was used to select the subjects who underwent CCTA examination from July to December 2020 as the research subjects,among which 37 cases of patients in the first three months were the control group,and 37 cases of patients in the last three months were the observation group.The control group was given conventional health education,while the observation group also applied mind mapping at the same time.The score of state anxiety inventory(S-AI),the number of repeated preparations,per capita examination duration and patient satisfaction score were compared between the two groups.Statistical software SPSS22.0 was used to analyze the above data,including two independent samples t-test,paired sample t-test,one-way ANOVA,LSD-t test,Mann-Whitney U test and x~2test.P<0.05 was considered statistically significant.Results:(1)The effect evaluation of the optimal use strategy of contrast medium:Compared with group A,CT values and CNR of each vascular segment in group B were lower,but CT values were greater than 300HU and CNR was more than 8,which could meet the needs of clinical diagnosis.CT values of aorta and coronary artery branches in patients with different body weight in group A showed statistically significant differences(P<0.05).The differences in CT values of aorta and coronary artery branches in patients with different body weight in group B were not statistically significant(P>0.05).There was no significant difference in the image subjective score between the two groups(P>0.05).(2)In the evaluation of the application effect of mind mapping health education:Before intervention,there was no significant difference in S-AI score between the control group and the observation group(P>0.05).After intervention,S-AI score of patients in the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the number of repeated preparations between the two groups(P>0.05).The differences of per capita examination duration and the satisfaction score between the two groups were statistically significant(P<0.05).Conclusion:(1)In Revolution CT coronary angiography,the injection scheme based on iodine delivery rate can not only optimize the use of iodine contrast media,but also achieve consistent vascular enhancement effect among different patients.(2)The content of health education presented in the form of mind mapping can effectively relieve the anxiety degree of elderly patients in CCTA examination,shorten the length of per capita examination and improve patients’satisfaction with medical treatment,which provide effective nursing guarantee for the smooth implementation of the examination. |
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