肿瘤患者发生输液性静脉炎的相关因素分析

Analysis of related factors of infusion phlebitis in patients with tumor

目的分析肿瘤患者发生输液性静脉炎的相关因素。方法以3所医院共119例肿瘤患者为研究对象。自患者入院第一天输液起连续观察5 d,记录患者静脉炎发生情况及严重程度。在有无发生静脉炎及不同严重程度的静脉炎患者间进行各项相关因素的比较;并进一步行多元Logistic回归分析,分析发生静脉炎的危险因素。结果 57例(47.9%,139例次)患者发生了静脉炎。多元Logistic回归分析显示,女性、有既往静脉炎史、体力状况差、化疗时间长、日输液量大、输注氯化钾和使用外周留置针均可增加患者发生静脉炎的风险。合并糖尿病、既往静脉炎史、体力差、使用外周留置针和钢针、化疗时间长、日输液量大、输注氯化钾、化疗药物和营养剂的患者的重度静脉炎发生率较高。结论肿瘤患者是发生输液性静脉炎的高危人群,可能的高危因素包括女性、体力差、有既往静脉炎史和接受化疗等。刺激性药物对局部静脉的刺激明显;外周静脉用药对血管的刺激较大,可酌情考虑选择中心静脉通道。

Objective To investigate the related factors of infusion phlebitis in patients with tumor.Methods One hundred and nineteen patients with tumor were selected from three hospitals.Patients were observed for 5 d from the first day of infusion after admission,and the prevalences and severity of phlebitis were recorded.Related factors of infusion phlebitis were compared between patients with and without phlebitis and among patients with different severity of phlebitis,and risk factors of infusion phlebitis were further explored by multiple Logistic regression analysis.Results Phlebitis was observed in 57 patients(47.9%,139 case-times).Multiple Logistic regression analysis revealed that female gender,history of phlebitis,poor physical status,long time of chemotherapy,large amount of infusion per day,potassium chloride infusion and receiving infusion through peripheral intravenous needle could increase the risks of phlebitis.Patients with diabetes mellitus,history of phlebitis,poor physical status,receiving infusion through peripheral intravenous needle and steel needle,long time of chemotherapy,large amount of infusion per day,potassium chloride infusion,chemotherapeutics infusion and nutrient solution infusion were more likely to have severe phlebitis.Conclusion Patients with tumor are high risk group of phlebitis,and the possible high risk factors include female gender,poor physical status,history of phlebitis and receiving chemotherapy.Irritant drugs may lead to obvious topical venous stimulation.Central venous catheter may be preferred due to obvious irritation through peripheral infusion.