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[摘要] 目的:探讨化疗性静脉炎的临床特点,并提出相应护理对策。方法:选取625例行静脉化疗的恶性肿瘤患者,统计其化疗性静脉炎发生的严重情况及与输液途径和化疗药物刺激性强弱的关系。结果:外周分支静脉组、外周静脉主干组、中心静脉组静脉发生率分别为68.3%、12.7%、7.4%,强刺激药物组、一般刺激性药物组、无刺激性药物组静脉发生率分别为79.8% 、46.8%、6.2%,严重静脉炎主要发生于外周分支静脉且输入强刺激药物组。结论:静脉炎的发生率及严重程度与输液途径和化疗药物的刺激性强弱有关,严重静脉炎主要发生在前臂外周分支静脉组和输入强刺激性化疗药物时,加强健康教育、根据化疗药物刺激性强弱合理选择输液途径以及正确掌握化疗药物的输注浓度和方法是减少化疗性静脉炎的护理对策。
[关键词] 化疗性静脉炎;临床特点;护理对策
[中图分类号] R473.73 [文献标识码]C [文章编号]1674-4721(2010)07(a)-126-02
The clinical features of chemotherapeutic phlebitis and its nursing strategy
PU Huaizhi
(Department of Oncology, Affiliated Hospital of Panzhihua University, Panzhihua 617000, China)
[Abstract] Objective: To probe the clilical features of chemotherapeutic phlebitis, and search for the related nursing strategy. Methods: 625 patients with m alignant tumor were treated with chemotherapeutic drugs via veins, the state of phlebitis and the relationships between intake methods and the stimulation of chemotherapeutic drugs were investigated. Results: The rate of phlebitis in external jugular veins was 68.3%, in peripheral stem veins was 12.7% and in deep vein was 7.4%. The rate of phlebitis in hyper-stimulation chemotherapeutic drugs was 79.8%,in general-stimulation was 46.8% and in nontoxicant was 6.2%. The serious phlebitis were mainly associated with external jugular veins and hyper-stimulation chemotherapeutic drugs. Conclusion: The rate and serious level of phlebitis were associated with intravenous administration and the level of stimulation for chemotherapeutic drugs. The serious phlebitis of m alignant tumor patients happened mostly in external jugular veins and hyper-stimulation chemotherapeutic drugs. The nursing strategy to reduce the rate of chemotherapeutic phlebitis is to take the knowledge of chemotherapy for patients with m alignant tumor and select suitably intravenous administration by the level of stimulation for chemotherapeutic drugs and pay attention to the consistency or treatment methods of chemotherapeutic drugs.
[Key words] Chemotherapeutic phlebitis; Clinical features; Nursing strategy
静脉化疗是治疗恶性肿瘤的主要方法之一,由于化疗药物的局部刺激作用以及操作不当等因素,化疗性静脉炎发生率居高不下,不但给患者带来了痛苦,也增加了护理人员静脉穿刺的难度,给继续治疗造成一定的困难,从而影响化疗的效果。
1 资料与方法
1.1 一般资料
研究抽取2008年7月1日～2010年3月31日在攀枝花学院附属医院住院并行静脉化疗的恶性肿瘤患者共625例,其中,男性350例,女性275例,平均年龄(56.7±17.6)岁,平均化疗(5.2±1.6)个疗程。
1.2化疗性静脉炎判断标准
根据美国静脉输液护理协会静脉炎标准分为4级。1级:输液部位发红,伴有或不伴有疼痛;2级:输液部位疼痛,伴有发红和(或)水肿;3级:输液部位疼痛,伴有发红和(或)水肿,静脉有条索状改变,可触摸到结节;4级:输液部位疼痛,伴有发红和(或)水肿,有条索状物形成,可触及的静脉条索状物,长度>2.54 cm,有脓液流出。
1.3观察指标
化疗性静脉炎患者的给药途径、化疗药物分类和静脉炎严重程度。
1.4资料处理
调查资料选用SPSS 17.0软件包进行统计分析。
2 结果
2.1静脉炎发生与输液途径的关系
625例患者静脉炎发生率为52.0%(325/625)。其中,外周分支(前臂)静脉组静脉炎发生率为68.3%(310/454),外周静脉主干(头、正中、贵要静脉)组静脉炎发生率为12.7%(7/55),中心静脉组(全部为锁骨下静脉置管)静脉炎发生率为6.9%(8/116),具体见表1,经研究比较发现,3种输液途径静脉炎发生率差异有统计学意义(χ2=177.29,P0.05),而对于外周分支静脉组不同输液途径静脉炎发生率差异有统计学意义(χ2=109.9,P 高维列表分层对数线性分析示输液途径和化疗药物之间,χ2=0.127,P=0.998,而对于外周分支静脉组不同化疗药物静脉炎发生率,χ2=109.9,P
