静脉化疗时静脉炎发生的相关因素分析

Phlebitis in Cancer Patients Treated with Chemotherapy and Its Correlates

目的探讨化疗时影响静脉炎发生的相关因素。方法共1016例恶性肿瘤患者接受静脉化疗,所用化疗药物根据其毒性分为发疱药、刺激药及无毒性药。所用静脉总例数为1608例,共分5组:深静脉组、颈外静脉组、外周静脉主干组、分支静脉组1、分支静脉组2。观察静脉炎的发生率,并分析其发生的相关因素。结果同组静脉使用发疱药时,其静脉炎发生率高于使用非发疱药(P<0.01);使用刺激药时,静脉炎发生率高于无毒性药(P<0.01);同一化疗方案时,分支静脉组静脉炎发生率高于其他静脉组(P<0.01);同组静脉接受氟脲嘧啶不同化疗方案时,5d组静脉炎发生率较2d组和4～6h方案为高(P<0.01),2d组静脉炎发生率又高于4～6h方案(P<0.01);同组静脉接受3个疗程以上化疗时,其静脉炎发生率高于1、2个疗程化疗时(P<0.01),接受2个疗程化疗时,静脉炎发生率则高于1个疗程化疗时(P<0.01)。结论化疗时静脉炎的发生与化疗药物种类、化疗方案、疗程以及血管的粗细有关。

Objective To explore phlebitis related factors in cancer patients treated with chemotherapeutic drugs via veins. Methods One thousand and sixteen cases of patients with malignant tumors were treated with chemotherapeutic drugs via veins. The chemotherapeutic drugs were vesicant,irritant, or nontoxicant. The veins employed were 1608 in number, and could be classified into 5 groups,Group A：deep vein. Group B： external jugular vein. Group C： peripheral stem veins. Group D：the first branch veins from the peripheral stem veins. Group E： the second branch veins from the peripheral stem veins. And rate of phlebits were obsreved in five groups and analysed the related factors. Results For the same group of veins, the rate of phlebitis in vesicant was significantly higher than that in irritant,or nontoxicant（ P 〈0.01） ,and the rate of phlebitis in irritant was significantly higher than that in nontoxicant （P 〈0. 01）. For the same chemotherapeutic plan,the rate of phlebitis in group of branch veins was significantly higher than that in other groups（ P〈0.01）. The rate of phlebitis in the patients treated with one course of Flurouracil via Baxter syringe pump for 5 days was significantly higher than that for 2 days or for 4-6 hours（ P 〈0.01） ,and that for 2 days was significantly higher than that for 4-6 hours（ P〈0.01）. The differences of rate of phlebitis were significant among different course in the same group of the same plan. The rate of phlebitis in the veins employed for 3 courses of chemotherapeutic drugs treatment was significantly higher than that for 1 or 2 courses of chemotherapeutic drugs treatment （P 〈 0.01）,and the rate of phlebitis in the veins employed for 2 courses of treatment was significantly higher than that for 1 course（ P〈0. 01）. Conclusions The phlebitis of cancer patients happened in the chemotherapeutic treatment is related with chemotherapeutic drugs, plan,and the times of the courses of treatment.