化疗药物外渗原因分析及护理干预体会

Extravasation of chemotherapeutic drugs cause analysis and nursing intervention experience

目的探讨化疗药液外渗的原因，提出护理干预，减少外渗的发生。方法采用回顾性方法，对2009年1月～2012年1月的857例化疔出院患者的资料进行统计分析。结果857例中化疗药液外渗的有72例次，外渗率为8．4％。手背穿刺外渗率20．83％，手腕穿刺外渗率44．44％，肘窝处穿刺外渗率31．94％，其他穿刺外渗率2．79％；首次化疗占9．87％，重复穿刺占9．55％：输液瓶次〉5占8．39％及用铂类药物占11．37％；发疱药物占10．69％，非发疱药物占4．43％。穿刺部位、解剖因素、生理因素、输液时间、药物刺激强度等都是引起化疗药液外渗的原因。结论选择合适的穿刺部位、提高静脉穿刺技术、做好知识宣教、缩短输液时间及合理安排输液顺序等都可减少化疗药物外渗的发生。

Objective To explore the causes of extravasation of chemotherapy drugs, nursing intervention, reduce the extravasation. Methods Using the retrospective method, on the 2009 January to 2012 year in January 857 cases of chemotherapy for discharged patients difference statistics. Results In 857 cases of chemotherapy drugs extravasation in 72 cases, extravasation rate was 8.4%; the rate of puncture extravasation was 20.83%; wrist piercing extravasation rate was 44.44%; fossa cubitalis place puncture extravasation rate was 31.94%; other puncture extravasation rate was 2.79%; the initial chemotherapy was 9.87%; repeated puncture accounted was 9.55%; the transfusion bottle 〉5 accounted was 8.59% and platinum drugs accounted was 11.37%. Blistering drug accounted was 10.69%; a blistering drug accounted was 4.43%. Conclusion the puncture site, anatomical factors, physiological factors, the duration of the infusion, drug stimulation intensity and so on is caused by chemotherapy medicine exosmosis reasons. Experience of selection of suitable puncture site, improve the venlpuncture technique, good education, shorten the infusion time and reasonable arrangement of infusion sequence can reduce chemotherapeutic drugs extravasation.