30种静脉用药序贯输注组间冲管液安全剂量研究

Safe dose of flushing fluid in sequential infusion groups of thirty kinds of intravenous drugs

目的测定临床常用30种静脉用药序贯输注过程中组间冲管液的安全剂量,为临床护理操作提供参考。方法选取临床上常用且能采用紫外分光光度仪测定药物吸光度的30种静脉用药作为实验对象,按照药品使用说明书将其配制成临床常用成品输液,模拟体外临床输注。输液结束时,更换与溶剂一致的0.9%氯化钠或者5%葡萄糖注射液作为冲管液,依次留取样本1 mL,共留取70个样本。利用紫外分光光度仪测定不同阶段冲管液量标本的吸光度,根据标准曲线计算浓度,当冲管液量样本浓度为0时,判定输液管内残留药液已被冲洗干净。结果30种静脉用药的冲管液体积24~65 mL,其中24~<30 mL 12种,30~<40 mL 10种,40~<50 mL 6种,50 mL 1种,65 mL 1种。22种(73.33%)药品组间冲管安全剂量在40 mL以内。结论多种静脉用药序贯输液时,当有配伍禁忌或无法确定有无配伍禁忌时,均需要使用安全剂量行组间冲管,以利于临床静脉用药安全。

Objective To determine the safe doses of flushing fluid between groups during sequential infusion of thirty kinds of commonly used intravenous drugs,so as to provide a reference for clinical nursing.Methods Thirty kinds of commonly used intravenous drugs in clinical settings and capable of measuring drug absorbance by ultraviolet spectrophotometer were selected as experimental subjects,then they were dispensed into clinically commonly usedⅣfluids to simulate in vitro clinical infusion according to the instructions of drug administration.At the end of the infusion,0.9%sodium chloride or 5%glucose injection consistent with the solvent was infused as the flushing fluid.Then a specimen of 1 mL was harvested,totalling 70,specimens.The absorbance of the specimens at different stages of flushing fluid volume was measured by ultraviolet spectrophotometer,and the concentration was calculated according to the standard curve,when it was zero,it demonstrated that the residual liquid in the infusion tube had been flushed clean.Results The volume of flushing fluid of the thirty intravenous drugs was 24-65 mL,of which 24-<30 mL had 12 kinds,30-<40 mL had 10 kinds,40-<50 mL had 6 kinds,50 mL and 65 mL each had 1 kind.The safe dose of flushing fluid between groups of twenty-two(73.33%)kinds of drugs was less than 40 mL.Conclusion In the sequential infusion of multiple intravenous drugs,when there is incompatibility or incompatibilities cannot be determined,it is necessary to use a safe dose fluid to flush the tube,which is conducive to the safety of clinical intravenous medication.