Spring D B, Winfield A C, Friedland G W, Shuman W P, Preger L
Department of Radiology, Letterman Army Medical Center, San Francisco, CA 94129.
AJR Am J Roentgenol. 1988 Dec;151(6):1243-5. doi: 10.2214/ajr.151.6.1243.
In a multiinstitutional study, we surveyed 902 patients who were undergoing IV contrast-enhanced CT or IV urography; the purpose of the study was to determine patients' reactions to being given a written description of some of the risks associated with radiographic contrast material just before undergoing the examination. Ninety percent of the patients who responded said they would rather receive this information than not receive it. Ten percent said they preferred not to be given the information. Limitations in obtaining a truly informed consent were not rare and occurred in patients with medical emergencies (3% of cases) and in those with a limited understanding of risk disclosure (11% of cases). Patients in the latter category included those who were comatose or semicomatose (2%), those with dementia (1%), those with aphasia (0.8%), those who had psychiatric problems (0.8%), those who were sedated (0.6%), those who were unable to read (2%), those who were unable to understand English (2%), and those who perceived the information as too technical (0.9%). Two percent of the patients were minors. Our survey shows that practical limitations in obtaining adequate risk disclosure are common, but most patients want and accept information about the risks of having IV contrast-enhanced CT or IV urography before undergoing the procedure.
在一项多机构研究中，我们对902名正在接受静脉造影增强CT或静脉肾盂造影的患者进行了调查；该研究的目的是确定患者在接受检查前收到有关放射造影剂相关风险的书面描述时的反应。做出回应的患者中有90%表示他们宁愿收到此信息也不愿不收到。10%的患者表示他们宁愿不被提供该信息。在获得真正知情同意方面存在的限制并不罕见，在医疗紧急情况患者（占病例的3%）和对风险披露理解有限的患者（占病例的11%）中都有发生。后一类患者包括昏迷或半昏迷患者（2%）、痴呆患者（1%）、失语患者（0.8%）、有精神问题的患者（0.8%）、接受镇静的患者（0.6%）、无法阅读的患者（2%）、不懂英语的患者（2%）以及认为信息过于专业的患者（0.9%）。2%的患者为未成年人。我们的调查表明，在获得充分风险披露方面存在实际限制很常见，但大多数患者在接受静脉造影增强CT或静脉肾盂造影检查前希望并接受有关风险的信息。
