盐酸利多卡因和地塞米松磷酸钠在预防化疗药物外渗中的应用

目的探讨盐酸利多卡因和地塞米松磷酸钠在预防化疗药物外渗中的作用。方法选择142例血管细、弹性差、多次静脉输液治疗的患者，随机分成治疗组和对照组。治疗组在输入化疗药物前先用2％盐酸利多卡因1ml、地塞米松磷酸钠5mg（2ml）加7ml生理盐水稀释缓慢静脉推注后，再输入化疗药物；对照组在化疗前静脉注入10ml生理盐水。结果治疗组Ⅰ期、Ⅱ期药物外渗发生率分别为8．5％和0，而对照组分别为26．8％与4．2％，两组差异有统计学意义（P〈0．05）；治疗组疼痛发生率分别为15．5％和1．4％，对照组分别为36．6％与9．9％，两组间差异有统计学意义（P〈0．05）。结论对于血管细、弹性差以及多次应用化疗药物的患者，化疗前应用盐酸利多卡因和地塞米松磷酸钠缓慢静脉推注，能显著减少化疗药物外渗和静脉炎的发生；同时，应加强观察及护理。

Preventive Effects of Lidocaine and Dexamethasone on Extravasation of Chemotherapeutic Drugs

Objective To study the preventive effects of lidocaine and dexamethasone on extravasation of chemotherapeutic drugs.Methods The total of 142 patients,who had thin blood vessels and poor elasticity of vessels and had frequent venous infusion,were randomly divided into treatment group and control group.Patients in the treatment group were given intravenous 2% lidocaine(1ml) and dexamethasone(5 mg) in 7 ml physiologic saline before intravenous transfusion of chemotherapeutic drugs;those in the control group were given intravenous normal saline(10 ml) before intravenous transfusion of chemotherapeutic drugs.Results The drug extravasation rate was markedly lower in the treatment group than in the control group,either at the I stage(9.70% vs 26.76%,P<0.05) or the II stage(0.00% vs 4.23%,P<0.05).Furthermore,the incidence of pain was significantly lower in the treatment group than in the control group,either at the I stage(15.49% vs 36.62%,P<0.05) or the II stage(1.40% vs 9.86%,P<0.05).Conclusions Intravenous injection of lidocaine and dexamethasone before intravenous transfusion of chemotherapeutic drugs can markedly reduce the incidence of drug extravasation and phlebitis in patients have thin blood vessels and poor elasticity of vessels or repeated intravenous transfusion.