黄连消肿膏防治化疗性静脉炎疗效观察

目的观察黄连消肿膏防治化疗性静脉炎的临床疗效。方法采用随机对照试验方法，将431例符合纳入标准的化疗患者随机分为黄连消肿膏组（216例）和硫酸镁组（215例）。黄连消肿膏组从静脉推注或滴注化疗药物的第1天起，常规皮肤消毒后，将黄连消肿膏平摊于3层无菌纱布上，外敷静脉穿刺处，每8h更换纱布1次；硫酸镁组采用传统的50％硫酸镁溶液湿敷治疗。两组均以5d为1个疗程，4个疗程后评价疗效。结果黄连消肿膏组在静脉炎发生率、静脉反应发生率、疼痛评分、客观疗效等方面与硫酸镁组比较，差异均有统计学意义（P〈0.05）。结论黄连消肿膏对化疗静脉具有保护作用，能防治化疗药物引起的静脉炎。     

75％乙醇湿敷预防周围静脉输入去甲长春花碱诱发静脉渗漏和静脉炎的研究

目的 探讨周围静脉输入强刺激性化疗药物（去甲长春花碱）时有效预防静脉渗漏和静脉炎的的方法。方法 选取周围静脉输入去甲长春花碱的肿瘤化疗患者120例，随机分为湿敷组及非湿敷组各60例，观察两组患者穿刺点渗漏及静脉炎的发生率。结果75％乙醇湿敷可有效降低强刺激性化疗药物对周围血管的刺激性。结论 此方法值得在是人床中推广应用。     

精密过滤输液器在减少注射用七叶皂苷钠不良反应中的作用

目的：探讨精密过滤输液器在减少输注七叶皂苷钠引发不良反应中的作用。方法：对136名住院并使用七叶皂苷钠,排除外周血管病变及静滴过程中药物外渗的患者,随机分为普通组和精密组,分别采用普通输液器和精密过滤输液器,对输液时疼痛及输液后静脉炎的发生率进行比较,应用疼痛标尺、INS静脉炎分级标准进行分级,并进行统计学处理。结果：在使用七叶皂苷钠后,患者疼痛程度及静脉炎的发生率方面,精密组要远远低于普通组具有统计学意义,P〈0.01。结论：使用精密过滤输液器可有效减轻输液时疼痛,并降低输液后静脉炎的发生率。     

静脉留置针导致静脉炎原因分析与对策

静脉留置针已广泛用于临床，使用不当可引起静脉炎。笔者对200例静脉留置针病人进行了观察，发现留置针引起静脉炎与穿刺部位的选择、输入药物的性质、输液量及封管方法等有关。采取相应措施可减少静脉炎的发生。     

Autoimmune pancreatitis: with special reference to a localized variant

In 2006, the Japan Pancreas Society revised the diagnostic criteria for autoimmune pancreatitis (AIP) so as to more clearly define its morphological, pathological, and immunological features, as follows: (1) diffuse or segmental narrowing of the main pancreatic duct with an irregular wall and diffuse or localized enlargement of the pancreas recognized by imaging studies; (2) high serum gamma globulin, IgG, or IgG4 levels, or the presence of autoantibodies; and (3) marked interlobular fibrosis and prominent infiltration of lymphocytes and plasma cells in the periductal area, occasionally with lymphoid follicles in the pancreas. Establishing a diagnosis of AIP has become easier with knowledge of its immunological abnormalities, including serum IgG4 levels. However, the localized form of AIP sometimes mimics pancreatic cancer. The rate of focal mass formation in patients with AIP is reportedly 24%–43%; however, there have been few reports on the histological findings of localized AIP, in contrast to mass-forming pancreatitis (MFP). Our review of patients who had undergone resection due to a preoperative diagnosis of MFP with possible cancer revealed 72% to be patients with localized AIP. For the discrimination of these conditions, it is important to recognize the characteristic ultrasonographic findings of AIP, i.e., (1) diffuse or localized enlargement and hypoechogenicity of the pancreas; (2) rarity of calcification, cystic lesions, and peripancreatic fluid collection; (3) thickened layer structure of the bile duct wall; (4) iso/hypervascularity in the swollen portion of the pancreas; (5) attenuation of pancreatic swelling and bile duct wall thickening after steroid therapy; and (6) multiple hypoechoic masses in various organs, including the pancreas. Contrast-enhanced endoscopic ultrasonography is potentially a useful tool in the differential diagnosis and for assessment of the efficacy of steroid therapy by enabling evaluation of the vascularity of the lesions. Along with the presence of IgG4-positive plasma cells, verification of obliterative phlebitis is highly specific for the histological diagnosis of AIP.     

两种方法预防化疗性静脉炎的疗效观察

目的探讨化疗性静脉炎的有效预防方法.方法将320例行静脉化疗的患者随机分为3组, 治疗Ⅰ组:在静脉化疗时,用新鲜芦荟叶片在穿刺处外敷(除针眼);治疗Ⅱ组:在静脉化疗时,用生土豆片在穿刺处外敷(除针眼);对照组:常规化疗,穿刺处未用任何方法外敷.结果应用芦荟叶片组和应用生土豆片组与对照组相比有显著性差异(P＜0.01),新鲜芦荟组与生土豆片组相比无显著性差异(P>0.05).结论新鲜芦荟或生土豆片外敷预防化疗性静脉炎效果明显,且取材方便,价格便宜,值得临床推广.     

静脉留置针致静脉炎相关因素分析及对策

目的了解静脉留置针病人发生静脉炎的因素,以便制订针对性的对策。方法对165例病人使用静脉留置针所致静脉炎的相关因素进行分析。结果静脉炎的发生与远端静脉穿刺、输入刺激性药物、液量大及封管药物技术等有关。结论通过合理选择静脉、正确输入药液、选择恰当的封管液、提高护理操作技术及健康教育可以降低病人静脉炎的发生率,保证静脉留置针的安全使用。     

紫外线、电磁场及药物治疗对白兔化疗性静脉炎的影响

目的 观察紫外线、电磁场及药物治疗对白兔化疗性静脉炎的影响。方法 向白兔耳缘静脉内注入长春瑞滨注射液，使其局部皮肤出现红肿热痛，从而制作化疗性静脉炎模型。共有12只日本大耳白兔制模成功。随机分为对照组、紫外线治疗组、电磁治疗组、药物治疗组，每组各3只白兔（共6只兔耳）。紫外线治疗组、电磁治疗组及药物治疗组分别给予紫外线照射、电磁辐射及药物治疗；对照组白兔未给予任何特殊处理。于实验进行4d后，分别对各组兔耳进行肉眼观察及病理组织学检查。结果 肉眼观察发现，紫外线治疗组与电磁治疗组症状改善较明显（P〈0．01），药物治疗组也有改善趋势，但与对照组比较，差异无统计学意义（P〉0．05）。经病理学检查后发现，紫外线治疗组和电磁治疗组的水肿消除作用明显（P〈0．01），药物治疗组水肿也有一定程度减轻，但与对照组比较，差异无统计学意义（P〉0．05）；电磁辐射还有一定的抑制纤维组织增生作用（与对照组比较，P〈0．05）。结论 紫外线治疗和电磁辐射对化疗性静脉炎均有良好的消炎、消肿功效．而且电磁辐射还能抑制纤维组织的增生。     

复方地黄酊湿敷治疗化疗性静脉炎的实验研究

[目的]探讨复方地黄酊湿敷对化疗药物所致家兔耳缘静脉炎的疗效.[方法]将36只成年家兔随机分为A组(空白对照组)、B组(应用复方地黄酊湿敷组)、C组(50%硫酸镁湿敷组),分别在家兔耳缘静脉注射盐酸多柔比星造成静脉炎模型,各采用不同治疗方法分别在治疗后2 h、4 h、6 h、24 h,用肉眼和组织病理学两种方法观察血管周围出血及水肿、炎性细胞浸润、血栓形成、血管壁增厚方面的变化.[结果]治疗后2 h、4h、6 h,B组、C组在炎细胞浸润、血栓形成、血管周围出血、血管周围水肿方面与A组比较,差异均有统计学意义(P＜0.05);治疗24 h,B组、C组差异具有统计学意义(P＜0.05).[结论]复方地黄酊湿敷可减轻化疗性静脉炎引起的局部组织损害,促进局部损伤组织修复,效果优于50%硫酸镁湿敷.     

Peripheral intravenous catheters in situ for more than 96 h in adults: What factors affect removal?

Peripheral intravenous catheters (PIVC) are widely used in clinical nursing, but indwelling time remains a subject of debate. This study aimed to assess the risk factors for PIVC phlebitis in adults and provide a basis for indwelling time decisions. A total of 189 first‐time PIVC patients in the emergency ward were assessed between May and October 2015. Data were retrieved for patient characteristics and PIVC assessment records. This study showed that over two‐thirds (67.72%) of PIVCs were removed because of phlebitis, including oedema (37.57%), rubefaction (33.33%), pain (32.28%), slow infusion speed (13.23%) and accidental extrusion (2.12%). PIVC indwelling time in the planned removal group was higher than that obtained for the unplanned removal group: 152.42 (74.58) vs. 94.64 (50.15) h, P < 0.001. At indwelling times > 96 h, 28.57% (n = 54) of catheters caused phlebitis, although 23.28% (n = 44) showed no phlebitis. PIVC phlebitis was associated with treatment with compound amino acid infusion (OR: 2.624), site at the elbow joint (OR: 3.049), haemoglobin level (OR: 2.492), white cell count (OR: 2.196) and catheter size (OR: 1.837). Study findings suggest that PIVC might be used for longer durations based on nursing assessments and health education.