静脉输注利福平致静脉炎循证分析及干预实践

Evidence-based Analysis and Intervention Practice of Intravenous Rifampicin-induced Phlebitis

目的应用根因分析法对静脉输注利福平注射液引起的静脉炎进行循证分类,并拟定干预实践方案。方法选取2018年1月—2019年1月我科收治的使用利福平注射液的420例患者,应用根因分析法对420例患者静脉输注利福平注射液引起的静脉炎进行循证分类,并拟定干预实践方案。结果420例患者均采取外周静脉留置输液,共发生静脉炎44例,发生率为10.48%;其中18例静脉炎发生于留置针留置3 d内,另外26例发生于留置3 d后;44例静脉炎中Ⅰ度19例,Ⅱ度22例,Ⅲ度3例;导致静脉炎发生的因素分别为药液滴速过快、药物浓度过高刺激性大、留置针留置时间过长和患者自行调节滴速。结论采取系列干预措施,如严格控制利福平注射液的补液滴速,保证药物适宜浓度,选择合适的静脉并缩短留置针留置时间,加强患者用药宣教及采取水胶体有效预防,均能有效防止利福平注射液引起的静脉炎。

Objective The root cause analysis method was used to classify the phlebitis caused by intravenous infusion of rifampicin injection, and the intervention practice was drawn up. Methods 420 patients who received rifampicin in our hospital from January 2018 to January 2019 were enrolled in 420 patients with phlebitis caused by intravenous infusion of rifampicin. Evidence-based classification, and draft intervention strategies. Results 420 patients were treated with peripheral venous infusion, and 44 cases of phlebitis occurred, the incidence rate was 10.48%;18 cases of phlebitis occurred within 3 days of indwelling needle, and another 26 cases occurred after indwelling for 3 days;44 cases of phlebitis. There were 19 cases of Ⅰ degree, 22 cases of Ⅱ degree, and 3 cases of Ⅲ degree. The factors leading to phlebitis were rapid drug droplet speed, high drug concentration, high irritant, indwelling needle indwelling time and patient self-regulating drip rate. Conclusion Take a series of interventions, such as strict control of the droplet speed of rifampicin injection, ensure the appropriate concentration of the drug, select the appropriate vein and shorten the indwelling time of the indwelling needle, strengthen the patient’s medication and take effective prevention of water colloid, can effectively prevent the benefit Phlebitis caused by Fuping injection.