5-氟尿嘧啶粉针输液泵输注超时原因分析及配制方法优化

Causal analysis on infusion timeout of 5-fluorouracil powder injection infusion pumps and the optimization for dispensing methods

目的探究5-氟尿嘧啶(5-FU)粉针输液泵输注超时原因,对其配制方法进行优化研究,为临床配制提供参考依据。方法测试5-FU在不同溶剂中的溶解效果;于2020年5月20日至7月20日在汕头大学医学院附属肿瘤医院收集临床数据,分析不同溶剂对输液泵超时的影响和影响输液泵超时的相关因素。结果不同溶剂对5-FU的溶解能力由强到弱为:注射用水>5%葡萄糖注射液(简称5%GS)>0.9%氯化钠注射液(简称0.9%NS)。注射用水组超时程度为(15.03±8.62)%,明显低于0.9%NS组(36.78±4.81)%、0.9%NS+注射用水组(22.50±7.22)%、5%GS组(25.53±6.21)%和5%GS+注射用水组(24.78±4.36)%,差异有统计学意义(t值为2.50~5.27,均P<0.05);0.9%NS组超时程度高于其余各组,差异有统计学意义(t值为3.65~5.27,均P<0.05)。统计得静脉输注组超时程度为(23.07±8.98)%,与动脉输注组的超时程度(60.60±58.64)%比较,差异有统计学意义(H=10.18,P=0.001),药液浓度和药液总容量分别与超时程度存在正相关(r=0.29,P=0.013)和负相关(r=-0.59,P<0.01);药液浓度、药液总容量和输注途径共同决定超时程度的67.3%。结论5-FU粉针输液泵的输注超时受药液浓度、药液总容量和输注途径共同影响。建议配制该输液泵时,适当提高注射用水比例,控制药液浓度和总容量,加以考虑动静脉输注的差异。

Objective To analyze the cause of infusion timeout of 5-fluorouracil(5-FU)powder injection infusion pumps,and conduct research on the dispensing methods,then provide a basis for clinical dispensing.Methods The dissolution effect of 5-FU in different solvents were tested in the lab.The effect of different solvents on infusion timeout of infusion pumps,and the factors related to infusion timeout of the pumps were explored by analyzing the clinical data which was collected in Cancer Hospital of Shantou University Medical College from May 20 to July 20,2020.Results The dissolving capacity to 5-FU of different solvents sorted by the influence in a descending manner as follows:water for injection>5%glucose injection(5%GS)>0.9%sodium chloride injection(0.9%NS).Infusion timeout value of water for injection group(15.03±8.62)%was lower than that of 0.9%NS group(36.78±4.81)%,(0.9%NS+water for injection)group(22.50±7.22)%,5%GS group(25.53±6.21)%and(5%GS+water for injection)group(24.78±4.36)%(t values were 2.50-5.27,all P<0.05).The timeout value of 0.9%NS group was higher than that of other groups(t values were 3.65-5.27,all P<0.05).There were differences in infusion timeout between intravenous infusion group(23.07±8.98)%and arterial infusion groups(60.60±58.64)%(H=10.18,P=0.001).There was a positive correlation between drug concentration and infusion timeout(r=0.29,P=0.013),and a negative correlation between total liquid volume and infusion timeout(r=-0.59,P<0.01).Infusion timeout of pumps was partly(67.3%)affected by drug concentration,total liquid volume and infusion route.Conclusions The research shows that infusion timeout of 5-FU powder injection infusion pumps is related to drug concentration,total liquid volume and infusion route.It is suggested that the percentage of water for injection,drug concentration,total liquid volume,and infusion route should be considered when 5-FU powder injection infusion pumps are prepared.