临床推理在夹层动脉瘤患者CT增强扫描检查中的应用_West China Medical Journal

Authors：

 敬茜 , 赵俐红 , 张正义 , 李伟

四川大学华西医院放射科（成都 610041）;

Corresponding author：

Keywords：

临床推理; 夹层动脉瘤; CT增强扫描; 护理

DOI：

10.7507/1002-0179.201600389

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目的总结临床推理模式在夹层动脉瘤患者CT增强扫描检查中的应用体会。方法回顾性分析2013年9月－12月临床推理在56例夹层动脉瘤患者行CT增强扫描检查中的应用。结果 56例夹层动脉瘤患者均顺利完成CT增强扫描检查，在检查期间未发生对比剂过敏或外渗等不良事件，图像质量评级为优，图像清楚地显示夹层动脉瘤的位置、大小、破口、真腔、假腔、受累血管。结论在临床推理的不同阶段，根据患者情况，护士正确评估患者，实施正确的护理措施，以保证夹层动脉瘤患者顺利完成CT增强扫描检查，获得准确的检查结果，减少患者医源性损伤。

Citation： 敬茜, 赵俐红, 张正义, 李伟. 临床推理在夹层动脉瘤患者CT增强扫描检查中的应用. West China Medical Journal, 2016, 31(8): 1431-1433. doi: 10.7507/1002-0179.201600389 Copy

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1. Levett-Jones T, Hoffman K, Dempsey J, et al. The "five rights" of clinical reasoning:an educational model to enhance nursing students' ability to identify and manage clinically "at risk" patients[J]. Nurse Educ Today, 2010, 30(6):515-520.
2. De León Ayala IA, Chen YF. Acute aortic dissection:an update[J]. Kaohsiung J Med Sci, 2012, 28(6):299-305.
3. Lin EC. Coronary computed tomography angiography:principles of contrast material administration[J]. J Cardiovasc Comput Tomogr, 2007, 1(3):162-165.
4. Forsberg E, Georg C, Ziegert K, et al. Virtual patients for assessment of clinical reasoning in nursing——a pilot study[J]. Nurse Educ Today, 2011, 31(8):757-762.
5. 梁长虹, 冯晓源, 郭启勇, 等.对比剂使用指南[J].中华放射学杂志, 2013, 47(10):869-871.
6. 周曙光, 刘友新.碘对比剂在放射科的使用[J].实用医技杂志, 2012, 19(11):1172-1173.
7. Morcos SK, Thomsen HS, Webb JAW, et al. Contrast media induced nephrotoxicity:a consensus report[J]. Eur Radiol. 1999, 9(8):1602-1603.
8. Hoffman K, Donoghue J, Duffield C. Decision-making in clinical nursing:investigating contributing factors[J]. J Adv Nurs, 2004, 45(1):53-62.
9. Linn A, Khaw C, Kildea H, et al. Clinical reasoning-a guide to improving teaching and practice[J]. Aust Fam Physician, 2012, 41(1/2):18-20.
10. 孙燕, 田洋.主动脉夹层的护理进展[J].山西医药杂志, 2012, 41(4):363-365.
11. 赵曙光, 王旭霞, 赵保民, 等.临床推理研究进展[J].西北医学教育, 2008, 16(1):16-17, 41.
12. 王磊, 杨依, 蒋晓莲, 等.临床推理与决策课程对护理本科生评判性思维能力的影响[J].中华现代护理杂志, 2012, 18(2):186-188.
13. Banning M. Clinical reasoning and its application to nursing:concepts and research studies[J]. Nurse Educ Pract, 2008, 8(3):177-183.
14. Brink JA, Wang G, McFarland EG. Optimal section spacing in single-detector helical CT[J]. Radiology, 2000, 214(2):575-578.

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