国内化疗性静脉炎预防护理的临床证据及评价

Clinical evidences and evaluation of preventive care of chemotherapeutic phlebitis in China

目的调查国内预防化疗性静脉炎的护理研究现状,并评价证据强度及存在问题。方法应用计算机检索2005年1月～2011年6月国内5本护理核心期刊中关于预防化疗性静脉炎的随机对照研究文献,严格质量评价后进行分析。了解国内预防化疗性静脉炎的护理研究现状,并评价证据强度及存在问题。结果最终纳入24篇研究,17篇探讨药物外敷或外涂(其中单一药物外敷或外涂8篇、联合药物外敷9篇)、2篇探讨药物冲管(内用药物)的预防护理、2篇为药物冲管加外敷(外用和内用药物)的联合防治、3篇探讨非药物应用(特殊透明贴及精细过滤器的应用);国内预防化疗性静脉炎的文献证据强度不足;判定标准不统一,且结局指标单一。结论今后应该开展设计更加严谨的大样本、高质量的随机对照研究,而且应注重开展非药物方法预防化疗性静脉炎、复合指标判断化疗性静脉炎疗效的研究。

Objective To review the current nursing research in preventing chemotherapeutic phlebitis in China and to evaluate evidence strength and find out the problems. Method A online retrieval on 5 nursing journals concerning the prevention of chemotherapeutic phlebitis in recent five years, strict assessment over the nursing quality and the analysis was done. Results 24 papers were finally sorted out ： 17 of them probed into external application of medicine, 2 preventive nursing after washing tube with medicine, 2 joint prevention after washing tube with medicine and external application of medicine and 3 the application of non-medicine. The evidence for prevention of chemotherapeutic phlebitis was not robust, the standard was not uniform and the indexes for conclusions were few. Conclusions A large sample, high quality of randomized controlled study should be designed and carried out in the future. We should explore more methods to prevent chemotherapy phlebitis besides medication and attach importance to composite indexes for evaluating the curative effect of chemotherapy phlebitis.