Page 7 - 《中国药房》2024年1期

·指南与共识·

碘对比剂全程化药学服务共识

中国医药教育协会临床合理用药专业委员会，广东省药学会用药评价与临床科研专家委员会

中图分类号 R95；R981 文献标志码 A 文章编号 1001-0408（2024）01-0001-09
DOI 10.6039/j.issn.1001-0408.2024.01.01

摘 要 目的 探讨碘对比剂全程化药学服务模式，促进碘对比剂的临床合理使用。方法 中国医药教育协会临床合理用药专业
委员会和广东省药学会用药评价与临床科研专家委员会组织国内专家，成立《碘对比剂全程化药学服务共识》工作组，针对碘对比
剂的发展历程、适应证、禁忌证、不良反应、药物相互作用、特殊人群用药、药学服务等进行文献检索、循证分析和研讨，梳理全程化
药学服务的内容与流程，最终形成共识。结果 制定的碘对比剂全程化药学服务共识包括检查前对患者、肾功能、合并用药和水化
方案的评估，检查中有无发生对比剂外渗或发生（可疑）急性不良反应，检查后的观察时间点和随访等内容，以药学服务流程图展
示各阶段的具体工作，并形成用药监护记录表用以记录工作情况。结论 本共识构建了碘对比剂全程化药学服务体系，为临床医
生、护理人员合理使用该类特殊药品提供了科学依据，也为药师进行相关药学服务提供了参考。
关键词 碘对比剂；合理用药；药物不良反应；药学服务；全流程；共识

Consensus on whole-process pharmaceutical care for iodine contrast medium
Clinical Professional Committee on Rational Drug Use of China Medical Education Association， Expert
Committee on Drug Evaluation and Clinical Research of Guangdong Pharmaceutical Association

ABSTRACT OBJECTIVE To explore the whole-process pharmaceutical care model of iodine contrast medium and promote the
rational clinical use of iodine contrast medium. METHODS Clinical Professional Committee on Rational Drug Use of China
Medical Education Association and Expert Committee on Drug Evaluation and Clinical Research of Guangdong Pharmaceutical
Association organized domestic experts to establish a working group on the Consensus on the whole-process pharmaceutical care for
iodine contrast medium. The working group conducted literature searches， evidence-based analysis， and discussions on the
development process， indications， contraindications， adverse drug reactions， drug interactions， drug use for special population，
pharmaceutical care， and other key topics to summarize the content and process of the whole-process pharmaceutical care for iodine
contrast medium. This consensus was ultimately formed. RESULTS The consensus on whole-process pharmaceutical care for iodine
contrast medium included an evaluation of the patient， renal function， combined drug use， and hydration regimen before
examination， the presence of contrast agent extravasation or suspected acute adverse reactions during examination， observation time
points and follow-up after examination， and the presentation of specific work in each stage through pharmaceutical care flowchart.
The medication monitoring record form was also formed to record the work situation. CONCLUSIONS The consensus has
established a whole-process pharmaceutical care system for iodine contrast medium， providing scientific evidence for clinical
physicians and nursing staff in the rational use of such special drugs， and also serving as a reference for pharmacists in providing
related pharmaceutical care.
KEYWORDS iodine contrast medium； rational drug use； adverse drug reactions； pharmaceutical care； whole-process； consensus

碘原子的相对原子质量为127，较人体其他原子大， 的含碘对比剂称为碘对比剂（iodine contrast medium，
吸收X射线的性能强，进入人体后能在被检部位造成密 ICM），ICM在临床上常用于CT血管增强造影、CT灌注

度差别而形成影像对比，有利于显示腔道形态，且其结 和体腔、关节、脊髓造影等。
随着 CT 扫描设备和技术的不断发展，ICM 的临床
构稳定、生物毒性低。一类由碘原子与不同化合物形成
应用越来越广泛。临床使用 ICM 过程中可能会发生血
通信作者 王勇：教授，博士。研究方向：临床药学。E-mail：
管外渗、急性不良反应甚至造影后急性肾损伤（post con‐
yongwh2005@163.com
trast acute kidney injury，PC-AKI）等不良反应。与此同
通信作者 喻珊珊：主任药师，博士。研究方向：临床药学。
E-mail：hygeia1019@163.com 时，ICM 也可能与患者正在使用的药物发生相互作用，

中国药房 2024年第35卷第1期 China Pharmacy 2024 Vol. 35 No. 1 · 1 ·