以0.9%氯化钠注射液为盐酸胺碘酮注射液溶媒致静脉炎

Phlebitis due to 0.9% sodium chloride injection as solvent of amiodarone hydrochloride injection

1例59岁男性2型糖尿病患者因房颤需要持续静脉泵入盐酸胺碘酮注射液。因患者血糖水平较高,临床医师应用0.9%氯化钠注射液作为溶媒,以每毫升1 mg盐酸胺碘酮、1 ml/min的速度自左臂给患者持续静脉泵入。约1 h后患者左臂静脉通路走行区域皮肤出现红肿,皮温升高,伴明显疼痛。诊断为静脉炎,考虑与溶媒0.9%氯化钠注射液有关。立即将溶媒更换为5%葡萄糖注射液,将静脉通路更换至右臂,同时对发生静脉炎的局部给予冷敷处理。1 h后患者左臂静脉炎区域皮肤温度恢复正常,红肿及疼痛症状消失。

A 59-year-old male patient with type 2 diabetes mellitus needed to receive continuous intravenous pump infusion of amiodarone hydrochloride injection for atrial fibrillation. Considering the higher blood sugar levels of the patient, the clinician used 0.9% sodium chloride injection as the solvent and gave the infusion at the speed of 1 mg amiodarone hydrochloride injection per min via his left arm. About 1 hour later, the patient developed red and swollen on the skin around the venous access of his left arm with increased skin temperature and obvious pain. He was diagnosed as phlebitis, which was considered to be relevant with 0.9% sodium chloride injection. The solvent was changed to 5% glucose injection immediately and the infusion was given via the right arm. At the same time, the cold compress treatment was given on phlebitis area. One hour later, the skin temperature returned to normal and the symptoms of swollen and pain disappeared.