Davies A M, Evans N, Chandy J
Department of Radiology, Royal Orthopaedic Hospital, Birmingham.
Br J Radiol. 1989 Aug;62(740):716-23. doi: 10.1259/0007-1285-62-740-716.
A prospective study of 261 patients undergoing lumbar radiculography using 12 ml iopamidol (200 mgI/ml) was undertaken to determine whether the procedure could be performed safely on an outpatient basis. No statistically significant differences in the incidence and severity of side-effects were found between the 132 outpatients and 129 inpatient controls. Nine outpatients had to be kept in hospital at the end of a 4-h observation period and a further two outpatients were re-admitted to hospital because of severe side-effects. The current study was compared with a preceding study of identical design, already published, in which 200 patients underwent lumbar radiculography with 10 ml iohexol (240 mgI/ml). No statistically significant differences in the incidence and severity of side-effects between the two contrast media were evident up to 24 h after the examination. In the period between 24 h and 7 days, the incidence and severity of headache, nausea and dizziness were all significantly greater in the iopamidol group. Although outpatient radiculography can be performed safely with both contrast media, the higher incidence of delayed side-effects in the iopamidol patients prompts the authors to express a preference for iohexol for intrathecal use. The increased incidence of adverse reactions in female patients and the literature comparing iopamidol and iohexol for myelography are discussed.
对261例使用12毫升碘帕醇（200毫克碘/毫升）进行腰椎神经根造影的患者进行了一项前瞻性研究，以确定该操作是否可以在门诊安全进行。在132名门诊患者和129名住院对照患者之间，未发现副作用的发生率和严重程度有统计学上的显著差异。9名门诊患者在4小时观察期结束时需要住院，另有2名门诊患者因严重副作用再次入院。将本研究与之前已发表的一项相同设计的研究进行了比较，在该研究中，200例患者使用10毫升碘海醇（240毫克碘/毫升）进行腰椎神经根造影。在检查后24小时内，两种造影剂的副作用发生率和严重程度没有统计学上的显著差异。在24小时至7天期间，碘帕醇组头痛、恶心和头晕的发生率和严重程度均显著更高。虽然使用两种造影剂门诊神经根造影都可以安全进行，但碘帕醇患者延迟副作用的发生率较高，促使作者表示更倾向于鞘内使用碘海醇。讨论了女性患者不良反应发生率的增加以及比较碘帕醇和碘海醇用于脊髓造影的文献。
