烧伤病人静脉输液渗漏原因分析与防治措施

Analysis,Prevention and Cure for Intravenous Transfusion Leakage in Burn Patients.

目的:目的:分析严重烧伤救治过程中静脉输液渗漏的原因及防范措施。方法:总结作者2002年至2007年参与护理治疗的9例严重烧伤并发静脉输液渗漏病人的临床资料,分析液体渗漏的主要因素,临床特点,处理方法及防范措施。结果:9例病人均为周围静脉穿刺输液患者,事前曾接受过输入高渗液体,或对血管内皮细胞产生损伤作用的药物治疗,输入液体种类依次为5%碳酸氢钠、氨基酸、氯化钾及多巴胺等;主要临床表现为患处(肢)疼痛、肿胀、局部皮温下降,或有表皮小水疱形成,严重者皮肤溃烂、渗出、坏死,经综合治疗痊愈出院,未留残疾。结论:严重烧伤病人周围静脉输液渗漏的原因比较复杂,除原发病导致毛细血管通透性增加外,与输入液体及药物的种类与性质密切相关。

Objective： To analyze the cause, prevention and cure for intravenous transfusion leakage. Method： Complicated with intravenous transfusion leakage, clinical data of 9 severe burn patients nursed with the involvement of author between 2002 and 2007 was reviewed to analyze main reason, clinical feature, treatment, prevention and cure of leakage. Results： 9 cases were all peripheral venipuncture patients. Before treatment, they were infused with hypertonic liquid, or treated with drugs that could produce damage to cardiovascular endothelium. The infusions were Sodium Bicarbonate 5%, amino acid, Potassium Chloride and Dopamine et al. Clinical manifestation were damaged part （limb） with pain, intumesce, skin temperature decreased locally, or small vesiculation in epidermis, more severely, skin ulcerated, exudation, necrosis. No disability was seen after discharge. Conclusion： Cause of peripheral venipuncture in severe burn patients is complex, not only resulted from capillary permeability increase due to protopathy, but related closely to sorts of infused liquids and drugs.