Wen Xueke, Huang Wanmin, Liao Chao, Zhao Xinyan, Xu Ge, Wang Xiaolin, Su Jiaqiong, Yang Guanghui, Shi Jinghua, Wu Xuewei, Tan Wei, Zhang Bin, Luo Chunliu
Department of Nursing, The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University), Zunyi, China.
Department of Radiology, The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, China.
Eur Radiol. 2025 Jul 31. doi: 10.1007/s00330-025-11889-3.
To evaluate the efficacy of 75% alcohol wet compression as a noninvasive treatment for contrast medium extravasation (CMEX) during contrast-enhanced computed tomography (CECT).
This randomized controlled trial, conducted from February 1, 2019, to July 1, 2023, at six tertiary centers, involved participants undergoing CMEX during CECT. They were randomized (1:1:1:1) into four groups: 75% alcohol wet compress (AG), 50% magnesium sulfate wet compression (MG), 0.05% dexamethasone wet compression (DG), and routine care (RG). The primary outcome was the percentage change in the swelling area from baseline to 4 h, 24 h, 48 h, and 72 h, categorized as < 25%, 25-50%, 50-75%, and 75-100%. Secondary outcomes included pain reduction and quality of life improvement over 3 days, assessed using the visual analog pain intensity scale (VAS) and dermatology life quality index (DLQI), respectively.
Overall, 168 participants were randomized with balanced baseline characteristics. At 24 h, 48 h, and 72 h, AG and DG had significantly higher response rates (75-100%) than MG and RG (all p < 0.001), with no differences between AG and DG (all p > 0.05). AG showed greater reductions in pain score (ΔVAS: 4.88 vs 3.52 vs 3.29 vs 3.19, p < 0.001) and DLQI score (ΔDLQI: 11.60 vs 7.81 vs 7.86 vs 7.48, p < 0.001) than DG, MG, and RG.
The 75% alcohol wet compress was as effective as the 0.05% dexamethasone wet compression and superior to other CMEX treatment methods, providing more effective pain relief and improving the quality of life.
ClinicalTrials.gov Identifier: ChiCTR2300067692.
Question Can 75% alcohol wet compression outperform standard treatments for CMEX in reducing swelling, alleviating pain, and improving quality of life? Findings Seventy-five percent alcohol compresses rival dexamethasone's efficacy while surpassing other treatments for pain and quality-of-life outcomes. Clinical relevance Seventy-five percent alcohol wet compression provides a steroid-free CMEX treatment, effectively resolving extravasation like dexamethasone while offering superior pain control and quality-of-life enhancement, potentially transforming clinical practice.
评估75%酒精湿敷作为一种非侵入性治疗方法，用于对比增强计算机断层扫描（CECT）期间造影剂外渗（CMEX）的疗效。
这项随机对照试验于2019年2月1日至2023年7月1日在六个三级中心进行，纳入了在CECT期间发生CMEX的参与者。他们被随机（1:1:1:1）分为四组：75%酒精湿敷组（AG）、50%硫酸镁湿敷组（MG）、0.05%地塞米松湿敷组（DG）和常规护理组（RG）。主要结局是从基线到4小时、24小时、48小时和72小时肿胀面积的变化百分比，分为<25%、25 - 50%、50 - 75%和75 - 100%。次要结局包括3天内疼痛减轻情况和生活质量改善情况，分别使用视觉模拟疼痛强度量表（VAS）和皮肤病生活质量指数（DLQI）进行评估。
总体而言，168名参与者被随机分组，基线特征均衡。在24小时、48小时和72小时时，AG组和DG组的有效率（75 - 100%）显著高于MG组和RG组（所有p < 0.001），AG组和DG组之间无差异（所有p > 0.05）。与DG组、MG组和RG组相比，AG组的疼痛评分降低幅度更大（ΔVAS：4.88 vs 3.52 vs 3.29 vs 3.19，p < ；0.001），DLQI评分降低幅度也更大（ΔDLQI：11.60 vs 7.81 vs 7.86 vs 7.48，p < 0.001）。
75%酒精湿敷与0.05%地塞米松湿敷效果相当，且优于其他CMEX治疗方法，能更有效地缓解疼痛并改善生活质量。
ClinicalTrials.gov标识符：ChiCTR2300067692。
问题75%酒精湿敷在减轻肿胀、缓解疼痛和改善生活质量方面是否优于CMEX的标准治疗方法？研究结果75%酒精湿敷与地塞米松疗效相当，但在疼痛和生活质量结局方面优于其他治疗方法。临床意义75%酒精湿敷提供了一种无类固醇的CMEX治疗方法，能像地塞米松一样有效解决外渗问题，同时在疼痛控制和生活质量改善方面表现更优，可能改变临床实践。
