玻璃酸酶预防诺维苯所致静脉炎的实验研究及临床应用

Experimental study and clinical appllication of hyaluronidase to prevention of phlebitis induced by vinorelbine

目的 探讨局部外用硝酸甘油、玻璃酸酶、2 %山莨菪碱、2 5 %硫酸镁预防诺维苯 (长春瑞滨 ,NVB)所致静脉炎的效果。方法 采用NVB 0 .7mg/kg静脉推注 ,在静脉推注NVB前 5min分别采用上述四种药物溶液涂抹兔耳缘静脉的局部皮肤 ,静脉推注后于 0 ,0 .5 ,1,2 ,3h沿静脉走向涂抹。以穿刺点及距穿刺点 2cm为中心 ,各切下面积为 1cm2 的耳廓组织 ,福尔马林固定 2 4h做病理检查。2 3例患者应用NVB前后采用玻璃酸酶溶液涂抹 ,方法同动物实验 ,并与对照组相比较。结果 应用不同药物涂抹后NVB对兔耳缘静脉及周围组织的损害以玻璃酸酶组最轻。临床实验组静脉炎发生率为 3.9% ,疼痛程度评分 3.92± 1.2 5 ,疼痛持续时间 2 .4 2± 0 .5 8d ;对照组静脉炎发生率为 2 9.4 % ,疼痛评分 6 .2 6± 1.96 ,疼痛持续时间 8.2 5± 2 .4 1d ,两组差异有显著性。结论 应用玻璃酸酶溶涂抹局部血管可有效地预防静脉炎的发生。

Objective To evaluate the ef fi cacy of nitroglycerin, hyaluronidase,2% anisodomine and 25% MgSO 4 in preventin g phlebitis indued by vinorelbine (NVB).Methods The four above remedies were smeared on the rabbits skin over the marginal a uricular vei n 5 minutes before injection of NVB 0.7 mg/kg into the vein,then smeared al ong t he same vein 0,0.5,1,2,3 hours after injection respectively.Auricle tissue about 1 cm2 in size was cut with the venepunctune point and 2 cm away from the point as the center,and was fixed in formalin for 24th for pathological e x amination.Twenty-three patients received hyaluronidase smealing before and afte r application of NVB with the method same as in animal study and the results wer e compared with those of the control group.Results Hyaluronidase group had the lightest toxicity to the rabbit marg inal auricular veins and their peripheral tissue among different remedy groups.In t he t est group the phlebitis incidence was 3.9%,the pairn score was 3.92±1.25 and t he pain lasting time was 2.42±0.58 days.In the control group,the phlebitis incidence was 29.4%,the score of pain was 6.26±1.96 and the pain lasting time was 8.25±2.41 days.The difference between the two groups showed sta tistica l significance.Conclusion Smearing hyaluron idase on the skin over the local vein can prevent phlebitis effectively.[