预防MRI检查中的事故和伤害

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                    <p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="font-family: 宋体; line-height: 32px; text-indent: 28px; widows: auto;">磁共振成像(MRI)兴起于上世纪70年代末期，是一项前所未有的人体组织结构二维三维成像检查方法。到2008年，美国约有1000万人接受MRI检查</span><span style="font-family: 宋体; line-height: 32px; text-indent: 28px; widows: auto;">。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="font-family: 宋体; line-height: 32px; text-indent: 28px; widows: auto;">尽管MRI的作用显而易见，但其固有的危险却鲜为人知。以下是MRI扫描过程中发生损伤的类型：</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="widows: auto; line-height: 32px; text-indent: 28px; max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">1</span><span style="widows: auto; line-height: 32px; text-indent: 28px; max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">．当有铁磁性的物体，如钢笔、轮椅、氧气罐等被带入在高速运转的MRI高磁场中可能出现“导弹效应”或抛射伤害。</span><br  /></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: center; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><iframe src="https://v.qq.com/iframe/player.html?vid=f0019euk38y&auto=0" width="100%" height="580" frameborder="0"></iframe><br  /></p><h1 style="text-align: center;">视频：核磁共振检查 金属勿入</h1><p><img data-s="300,640" data-type="png" data-ratio="1.089928057553957" data-w="" width="auto" src="http://mmbiz.qpic.cn/mmbiz/dhvw8y1GyQ6VlFpibLq8MUzEG8v7rZiabawGtZWSNKiamU0LvpibHgy0fyN6G0HwSP8GbkhHoGR8g09Qrwh98mkFnQ/640?wx_fmt=png" style="color: rgb(62, 62, 62); line-height: 28px; text-align: center; white-space: pre-wrap; box-sizing: border-box !important; word-wrap: break-word !important; width: auto !important; visibility: visible !important;"  /></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: left; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">2</span><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">．铁磁性植入物</span><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">移位、脱落导致的伤害，例如：动脉瘤夹、关节内固定装置、药物输注装置等。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: left; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">3</span><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">．在磁共振成像过程中由会发热的物体产生的烧伤，例如：电线(包括导线植入和外部设备)和手术器械；或病人身体接触到MRI扫描仪的内壁造成的烫伤。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: left; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">4</span><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">．由于磁场干扰引起一些设备故障而造成伤害或并发症，例如电池驱动设备(喉镜、微量注射泵、监视器等)会突然失灵，一些编程输液泵可能注入剂量不准确；心脏起搏器和植入式心脏复律除颤器可能不按程序执行其功能。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: left; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">5</span><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">．</span><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">病人在核磁共振扫描期间，由于其生命维持系统出现问题而造成伤害或并发症。特别是那些处于镇静或麻醉状态的病人在</span><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: Arial, sans-serif; box-sizing: border-box !important; word-wrap: break-word !important;">MRI</span><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">检查时，这种情况很可能发生。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: left; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">例如，在</span><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: Arial, sans-serif; box-sizing: border-box !important; word-wrap: break-word !important;">MRI</span><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">扫描时，氧气袋内氧气耗尽或输液泵已输空，这时护理人员必须离开</span><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: Arial, sans-serif; box-sizing: border-box !important; word-wrap: break-word !important;">MRI</span><span style="line-height: 32px; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">区域去补充氧气、输液，或者将病人转移到可以补充氧气或输液的地方。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; margin-bottom: 10px; text-align: left; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">6</span><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">．核磁共振成像扫描仪发出的巨大噪声致声损伤。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: left; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><img data-s="300,640" data-type="png" data-ratio="0.7468354430379747" data-w="474" width="auto" src="http://mmbiz.qpic.cn/mmbiz/dhvw8y1GyQ6VlFpibLq8MUzEG8v7rZiabaesFUrWpDCUO5yOKSgqH4wTkbp0SNchvvvicR3iawiaJZr7LYtG3xicwEow/640?wx_fmt=png" style="box-sizing: border-box !important; word-wrap: break-word !important; width: auto !important; visibility: visible !important;"  /></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: left; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="line-height: 1.75em; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">7</span><span style="line-height: 1.75em; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">．核磁共振造影剂引起的副作用。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: left; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="line-height: 1.75em; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">8</span><span style="line-height: 1.75em; text-indent: 28px; widows: auto; max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">．超导核磁共振成像系统中致冷剂的处理、存储或泄漏引起的副作用。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: left; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="font-family: 宋体; line-height: 1.75em; text-indent: 28px; widows: auto;">到2008年，联合委员会的警讯事件数据库中有5例MRI相关伤害事件，涉及4个成人和1个孩子，其中4人死亡。1例抛射死亡，3例突发心脏病变死亡，1例是对MRI扫描误判而延误治疗。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: left; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><img data-s="300,640" data-type="png" data-ratio="0.6834532374100719" data-w="" width="auto" src="http://mmbiz.qpic.cn/mmbiz/dhvw8y1GyQ6VlFpibLq8MUzEG8v7rZiabaYyShQJVYjBgWFgR5DcwA1aicibeNzZ3XdvsvxbtoE5jbocViaKWeoBcBw/640?wx_fmt=png" style="box-sizing: border-box !important; word-wrap: break-word !important; width: auto !important; visibility: visible !important;"  /><span style="font-family: 宋体; text-indent: 28px;">发生在驱动MRI系统期间低温窒息事故。389例中70%以上是烫伤，10%抛射伤害，10%是“包括体内植入物失控及其他事故”，还有4%是声损伤，4%与火相关和2%与体内发热相关。</span><span style="line-height: 1.75em; widows: auto; text-indent: 28px; max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">2005</span><span style="line-height: 1.75em; widows: auto; text-indent: 28px; max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">年，美国急救医学研究所（ECRI）医学物理专家Jason Launders，利用FAD的制造商与用户设备数据库（MAUDE）进行了一项长达10年的独立研究，分析了389 例MRI相关伤害事件，其中9例死亡：3例与起搏器故障有关；2例胰岛素泵故障有关，其余4例是由于体内植入物干扰、抛射伤害、</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: left; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="line-height: 1.75em; text-indent: 28px; widows: auto; font-family: 宋体;"><br  /></span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: left; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="line-height: 1.75em; text-indent: 28px; widows: auto; font-family: 宋体;">在MRI检查中最常见的损伤是烫伤，最常见的受热物体是电线和导线。其他可引起烫伤的物体有：脉搏血氧计的传感器和连线，心肺监测仪的连线，安全别针，金属夹，膏贴(可能含有金属箔)和纹身(可能含有氧化铁颜料)。心脏起搏器很少引起烫伤。美国放射学会（ACR）</span><span style="line-height: 1.75em; text-indent: 28px; widows: auto; font-family: 宋体;">建议：将植入的心脏起搏器和植入式复律器/除颤器视为MRI的相对禁忌症。对这样的病人都应考虑意外的发生，需要有放射学和心脏病学知识的专业人员监护。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: center; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><img data-s="300,640" data-type="png" data-ratio="0.5964912280701754" data-w="456" width="auto" src="http://mmbiz.qpic.cn/mmbiz/dhvw8y1GyQ6VlFpibLq8MUzEG8v7rZiabaaibzp3WXyOvZTdrsYRpMjr3kzb15FViaiamTdXe1eY2NvfOgF8YA4ibfeQ/640?wx_fmt=png" style="box-sizing: border-box !important; word-wrap: break-word !important; width: auto !important; visibility: visible !important;"  /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-indent: 28px; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">虽然联合委员会只有1例抛射伤害报道,但实际上发生率并不低。包括医护人员在内的很多人，都没有意识到MRI的磁铁总是处于“开启”状态的，而把MRI的磁铁处于“关闭”（淬火）状态是一个昂贵、有潜在危险的操作，这包括MRI关闭时低温气体的释放，如果该低温气体被释放到一个密闭区域可能是窒息致命的。由于磁场的作用，许多清洁人员或维修人员的清洗设备或工具被吸入MRI扫描仪中。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-size: 18px; line-height: 36px; font-family: 黑体; color: rgb(112, 48, 160); box-sizing: border-box !important; word-wrap: break-word !important;">【降低风险的策略】</span></strong></p><p style="line-height: 1.75em; margin-bottom: 10px;">传统的金属探测器可用来检测患者体内或体外的金属物体，但它们并非100%准确，可能出现假阳性和假阴性。此外,金属探测器不能提醒工作人员所有的能在MRI扫描中可能制热、发生故障的物体。据ACR磁共振安全委员会主席Emanuel Kanal博士说，最近铁磁探测器能有效的检测出体内留有金属物件的病人。最近的一项研究结论指出铁磁探测器灵敏度高达99%。</p><p style="line-height: 1.75em; margin-bottom: 10px;">《美国放射学杂志》一篇关于抛射伤害事故的报告提出了防止此类事故的策略,这包括：只允许受过相关安全教育培训的维护和清洁人员，在没有病人接受检查的时候才能进入核磁共振区域。 Kanal博士也提出了在MRI环境中预防危险发生的许多措施，这些措施得到ECRI研究所的支持，包括：</p><p style="line-height: 1.75em; margin-bottom: 10px;">◆指定一名安全员负责实施和执行MRI检查中的安全规程。</p><p style="line-height: 1.75em; margin-bottom: 10px;">◆完善并支持安全MRI实践的系统，如定期审查规章制度和禁忌清单，并评估符合本医疗机构的政策、程序和安全协议。</p><p style="line-height: 1.75em; margin-bottom: 10px;">◆一般来说,任何设备或器械不得带入到核磁共振环境中,除非它是核磁安全或调磁安全的。核磁安全物体也并不是对所有核磁共振环境中都没有危害的，可调控的磁安全物体则在指定的核磁共振环境中以指定的方法使用时才不会造成已知的危害。</p><p style="line-height: 1.75em;"><img data-s="300,640" data-type="png" data-ratio="1.6901408450704225" data-w="284" width="auto" src="http://mmbiz.qpic.cn/mmbiz/dhvw8y1GyQ6VlFpibLq8MUzEG8v7rZiabaCI9C3CoibXlhxWV7QhnCN7DCDmMxj8NHOtn9dG6IXPZU4gCIhlyfybg/640?wx_fmt=png" style="box-sizing: border-box !important; word-wrap: break-word !important; width: auto !important; visibility: visible !important;"  /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-indent: 28px; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">可调控磁安全物体必须经过特殊的扫描仪和允许使用的磁共振环境所验证。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-indent: 28px; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: Helvetica, sans-serif; box-sizing: border-box !important; word-wrap: break-word !important;"> </span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-size: 18px; line-height: 36px; font-family: 黑体; color: rgb(112, 48, 160); box-sizing: border-box !important; word-wrap: break-word !important;">【联合委员会建议】</span></strong></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-indent: 28px; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">联合委员会为医疗健康保健组织减少MRI事故和伤害提出了以下建议和策略：</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-indent: 28px; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">1.</span><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">美国放射学会的《MRI安全操作指南:2007》，依据人员限制属性将MRI区域划分为四类：</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-indent: 21px; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">一区：一般人。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-indent: 21px; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">二区：未经检测筛选的MRI病人。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-indent: 21px; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">三区：检测筛选过的MRI患者和人员。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-indent: 21px; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">四区：在特定有经验的</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">MR</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">工作人员的直接监督下筛选MRI患者。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: center; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><img data-s="300,640" data-type="png" data-ratio="0.5326633165829145" data-w="398" width="auto" src="http://mmbiz.qpic.cn/mmbiz/dhvw8y1GyQ6VlFpibLq8MUzEG8v7rZiabauKCJrmPia5sITvsxBlKx081H38qZuibKluclNyE5JEQrjrBAIiaGhuv3Q/640?wx_fmt=png" style="box-sizing: border-box !important; word-wrap: break-word !important; width: auto !important; visibility: visible !important;"  /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-indent: 28px; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">2</span><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">．经过培训的工作人员对非紧急状态的患者进行两次筛选,提供两次单独的机会来询问病人是否携带任何金属物品、植入设备、膏药贴、纹身，和如何其他电、磁或机械活动设备。如果病人处于无意识状态或无法回答问题，则询问病人的家属或委托人。如果还不能确定，则通过其他方法来确定病人是否植入可能对核磁共振扫描带来不良影响的设备(如寻找疤痕或缺损、仔细查看病人病历、平片、使用铁磁探测器辅助筛选等)</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-indent: 28px; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">3</span><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">．确保核磁共振技术员获得病人完整、准确的病史，以确保病人可以安全地进行扫描。核对植入体的产品标签或制造商印制特定标识，或期刊数据中提及的有关设备或植入物问题。技术员应易于获得并清楚这些信息。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-indent: 28px; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">4</span><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">．配备受过培训并了解核磁共振环境的人员一直陪同病人、参观者和其他不熟悉核磁共振环境的工作人员。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: center; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><img data-s="300,640" data-type="png" data-ratio="0.8848920863309353" data-w="278" width="auto" src="http://mmbiz.qpic.cn/mmbiz/dhvw8y1GyQ6VlFpibLq8MUzEG8v7rZiabaR1yiatE6UcC9GHH7NKwCvBa1uV8rt8MdS3kXxE1TGa3wh9n3JYjh85A/640?wx_fmt=png" style="box-sizing: border-box !important; word-wrap: break-word !important; width: auto !important; visibility: visible !important;"  /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /><img data-s="300,640" data-type="png" data-ratio="0.45930232558139533" data-w="516" width="auto" src="http://mmbiz.qpic.cn/mmbiz/dhvw8y1GyQ6VlFpibLq8MUzEG8v7rZiabaq8Hy2synScnicS5Fic5LLRrA8hN6hTlENpz3WaPAIXJuy5xd7Vrb24FA/640?wx_fmt=png" style="box-sizing: border-box !important; word-wrap: break-word !important; width: auto !important; visibility: visible !important;"  /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-indent: 28px; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">5</span><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">．只使用经过测试和批准可以在MRI扫描中使用设备(如灭火器、氧气袋、生理监测仪、动脉瘤夹)<sup style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"> </sup>。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-indent: 28px; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">6</span><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">．对需要生命监测和连续注入维持生命药物的危重病人进行MRI检查时采取积极措施应对。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-indent: 28px; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">7</span><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">．为每位MRI检查者提供听力保护设备(耳塞)。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-indent: 28px; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">8</span><span style="max-width: 100%; font-family: 宋体; border: 1px none windowtext; box-sizing: border-box !important; word-wrap: break-word !important;">．不要在磁场区域内尝试进行心肺复苏。</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; text-align: center; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><img data-s="300,640" data-type="png" data-ratio="0.4064748201438849" data-w="" width="auto" src="http://mmbiz.qpic.cn/mmbiz/dhvw8y1GyQ6VlFpibLq8MUzEG8v7rZiabaulRqhulexu2BJG1QEA2eXBz7thiayQWBlf3R6ozkTYvj4E1d1oMvyFg/640?wx_fmt=png" style="box-sizing: border-box !important; word-wrap: break-word !important; width: auto !important; visibility: visible !important;"  /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /><img data-s="300,640" data-type="png" data-ratio="0.44244604316546765" data-w="" width="auto" src="http://mmbiz.qpic.cn/mmbiz/dhvw8y1GyQ6VlFpibLq8MUzEG8v7rZiabaafyTJ9mc9rtK47U7ibDzClXgfhevD1fJGWEnHLdiaqFq3gmK9N1RVuCg/640?wx_fmt=png" style="box-sizing: border-box !important; word-wrap: break-word !important; width: auto !important; visibility: visible !important;"  /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-size: 18px; line-height: 36px; font-family: 黑体; color: rgb(112, 48, 160); box-sizing: border-box !important; word-wrap: break-word !important;">【参考文献】略</span></strong></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">翻译：刘雪（重庆医科大学</span><span style="max-width: 100%; font-family: Arial, sans-serif; box-sizing: border-box !important; word-wrap: break-word !important;">2010</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">级七年制临床医学）</span></p><p style="max-width: 100%; min-height: 1em; white-space: pre-wrap; color: rgb(62, 62, 62); widows: auto; margin-bottom: 10px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: white;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">审校：周骊骊 </span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">康简 </span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">肖明朝（重庆医科大学附属第一医院）</span></p><p style="text-align: right; line-height: 1.75em;"><span style="color: rgb(62, 62, 62); font-family: 黑体; line-height: 32px; text-align: center; white-space: pre-wrap; background-color: rgb(255, 255, 255);">内容转载自《患者安全》微信公众号</span></p><p style="text-align: right; line-height: 1.75em;"><span style="color: rgb(62, 62, 62); font-family: 黑体; line-height: 32px; text-align: center; white-space: pre-wrap; background-color: rgb(255, 255, 255);"> 整理排版编辑</span></p>