胺碘酮致静脉炎的原因分析及护理

Reasons Analysis on Phlebitis Caused by Amiodarone and Relevant Nursing

目的探讨心律失常患者静脉应用胺碘酮致静脉炎的原因及护理。方法选取2014年3月~2015年3月某院收治的476例静脉点滴胺碘酮的心律失常患者,其中100例发生静脉炎,对这些患者资料进行分析,采用随机对照方法将患者分为对照组和实验组,实验组50例,男30例,女20例,年龄38岁~83岁,平均52.3±2.6岁;对照组50例,男27例,女23例,年龄39岁~83岁,平均51.7±2.3岁。对照组实施常规护理,实验组实施护理干预,比较两组护理效果。结果静脉炎患者中药物对血管的损伤引起20例,占20%;血管选择不合适30例,占30%;不成熟的穿刺技术引起18例,占18%;不合适的针头固定位置22例,占22%;药液外渗10例,占10%。实验组护理总有效率为96%,显著高于对照组的88%（P〈0.05）;实验组护理满意率为96%,显著高于对照组的72%（P〈0.05）。结论心律失常患者静脉应用胺碘酮导致静脉炎的原因是多方面的,不仅仅存在药物对血管损伤以及血管选择不当因素,同时也存在不熟练的穿刺技术和不恰当的针头位置固定,以及药液外渗。临床护理中既要加强患者的心理护理,也要选择合适的血管,提高穿刺成功率,做好血管的保护。

Objectives To investigate on the reasons of phlebitis caused by intravenous injection of amiodarone and relevant nursing in patients with arrhythmia. Methods 476 cases of arrhythmia patients who were treated by intravenous injection of amiodarone from March 2014 to March 2015 were enrolled in this research, and conducted analysis on the materials of the 100 cases of patients suffered from phlebitis among them. The patients were divided into control group and experimental group with the application of randomized controlled method. The experimental group contained 50 cases, 30 cases were male and 20 cases were female, the average age was 52.3 ＋ 2. 6 years old, while the control group contained 50 cases, 27 cases were male and 23 cases were female, and the average age was 51.7 ＋ 2. 3 years. The control group received routine nursing and the experimental group received nursing intervention, compared the nursing effect of the two groups. Results 20 cases were caused by the injury of drugs to blood vessel, accounting for 20%; 30 cases were caused by inappropriate selected of vein, accounting for 30%; 18 cases were caused by unskilled puncture technique, accounting for 18%; 22 cases were caused by unsuitable fixed position of needle, accounting for 22%; 10 cases were caused by drug extravasation, accounting for 10%. The total effective rate in the experimental group was 96%, which was significantly higher than that in the control group （88%） （P〈0. 05）. The nursing satisfaction rate of the experimental group was 96%, significantly higher than that of the control group （72%） （P〈0. 05）. Conclusions The reasons for phlebitis caused by intravenous injection of amiodarone in arrhythmia patients were various. Not only included factors such as the vein injury caused by drug and inappropriate selected of vein, but also unskilled puncture technique and unsuitable fixed position of needle could cause phlebitis. In clinical nursing, we should strengthen the psychological nursing of patients, and improve the success rate of puncture, as well as the protection of the blood vessels.