不同穿刺部位静脉留置针渗出外渗的发生现状及结局差异分析

Analysis of current situation and outcome differences of venous indwelling needle effusion and extravasation at different puncture sites

目的:探讨静脉留置针输液渗出外渗的发生现状,并对5种不同输液部位静脉渗出外渗情况、留置时间、渗出面积相关结局指标进行分析。方法:采用方便抽样法,选取2019年1—6月河南省19所医院住院并选用留置静脉针输液的患者为研究对象,通过专家小组讨论构建的临床输液报告表进行现状调查并分析其不同部位结局差异。共调查患者13594例,有效调查13284例,有效率为97.72%。结果:13284例静脉留置针输液患者中,发生静脉渗出外渗532例,发生率4.00%;其中手背静脉、前臂静脉、上臂静脉、头部静脉及下肢静脉渗出外渗的发生率分别为3.92%、3.90%、7.54%、2.74%、4.69%。不同穿刺部位在渗出外渗发生例数、留置时间和渗出外渗面积方面比较差异均有统计学意义(P<0.05),其中下肢静脉留置时间最短,渗出面积最大;手背静脉留置时间较长,渗出面积最小。结论:下肢静脉输液结局较差,手背静脉结局最佳,护理人员在进行输液时应根据患者的治疗计划制订合理的输液措施,加强巡视及预防措施,以减少静脉输液渗出外渗的发生。

Objective To explore the current situation of infusion effusion and extravasation of intravenous indwelling needle,and analyze the related outcome indicators of venous effusion and extravasation,indwelling time and effusion area of 5 different infusion sites.Methods Convenience sampling method was used to select patients hospitalized in 19 hospitals and with intravenous needles for infusion in Henan Province from January to June 2019 as the research object.The clinical infusion report form constructed by expert group discussion was used to investigate the current status and analyze the differences in outcomes of different sites.A total of 13594 patients were investigated,and 13284 were effectively investigated,with an effective rate of 97.72%.Results Among 13284 patients with intravenous indwelling needle for infusion,venous effusion and extravasation occurred in 532 cases,with an incidence of 4.00%;the incidence of effusion and extravasation of dorsal hand veins,forearm veins,upper arm veins,cephalic veins and lower limb veins were 3.92%,3.90%,7.54%,2.74%and 4.69%respectively.Different puncture sites had statistically significant differences in the number of cases of effusion and extravasation,indwelling time and area of exudation and extravasation(P<0.05).Among them,the indwelling time of lower limb veins was the shortest and the effusion area was the largest;the dorsal hand veins had a long indwelling time and the effusion area was the smallest.Conclusions The infusion in the lower limb vein was poor,and dorsal hand vein has the best outcome.Nurses should formulate reasonable infusion measures according to the patient's treatment plan during the infusion,strengthen inspections and preventive measures to reduce the occurrence of intravenous infusion effusion and extravasation.