静脉留置针患者发生静脉炎的影响因素分析

目的分析静脉留置针患者发生静脉炎的相关因素,为制定相应的预防护理措施提供依据,以提高输液护理质量。方法选择静脉留置针患者142例,分析患者性别、年龄、相关血液学指标、留置时间及封管方法对其静脉炎发生情况的影响。先进行单因素分析,再采用强迫法建立模型,用Logistic多元回归分析影响静脉炎发生的因素。结果本组发生静脉炎51例,发生率为35.9%。静脉炎发生与患者性别、留置静脉套管针的时间有关;与年龄、相关血液学指标及封管方法均无关。结论留置时间越长,发生静脉炎的可能性越大,女性较男性静脉炎发生率高,应尽可能缩短静脉留置套管针的时间,并加强对留置静脉留置针的女性患者的观察。     

金黄散外敷对PICC所致机械性静脉炎的预防和治疗效果观察

目的 探讨金黄散在PICC所致机械性静脉炎中的预防和治疗效果。方法 （1）将240例行PICC的肿瘤患者按置管先后顺序分为金黄散预防组和空白对照组,金黄散预防组于置管当天立即予金黄散外敷,连续3 d,空白对照组暂不予处理,观察两组机械性静脉炎的发生率;（2）将空白对照组中30例阳性病例随机分为金黄散治疗组和硫酸镁治疗组,金黄散治疗组予如意金黄散外敷,硫酸镁治疗组予50%硫酸镁湿敷,观察两种方法 对机械性静脉炎的治疗效果。结果 （1）金黄散预防组机械性静脉炎的发生率为3.3%,空白对照组机械性静脉炎的发生率为25.0%,金黄散预防组机械性静脉炎的发生率明显低于空白对照组（P〈0.001）;（2）金黄散治疗组在第8天即100%痊愈,而硫酸镁治疗组在第9天（观察截止日期）的痊愈率为86.6%,其中金黄散治疗组的痊愈中位时间为3.40 d,硫酸镁治疗组的痊愈中位时间为5.27 d,平均缩短1.87 d,金黄散治疗组机械性静脉炎的痊愈天数明显短于对照组（P〈0.05）。结论 采用金黄散外敷可有效预防和治疗PICC所致的机械性静脉炎。     

肝素盐水间断静脉推注预防化疗性静脉炎的效果观察

目的降低大肠癌病人大剂量醛氢叶酸 +氟尿嘧啶持续静脉滴注 48h所致静脉炎的发生率。方法将 5 5例晚期大肠癌病人随机分为对照组 2 0例和观察组 35例 ,对照组于持续滴注期间每 4h推注 0 .9%氯化钠注射液10 ml,拔针前再推注 2 0 ml冲管。观察组于持续滴注期间每 4h推注肝素盐水稀释液 (肝素钠 12 5 0 0 U +0 .9%氯化钠注射液 2 5 0 ml) 10 m l,拔针前推注 2 0 ml冲管。结果观察组静脉炎发生率 2 5 .7% (9/ 35 ) ,对照组 90 .0 % (18/ 2 0 ) ,两组比较 ,χ2 =2 1.0 46 ,P<0 .0 1,差异有极显著性意义 ;观察组未发生 、 度静脉炎。结论肝素盐水稀释液能有效降低大剂量醛氢叶酸 /氟尿嘧啶持续滴注 48h所致静脉炎的发生率 ,减轻静脉炎的严重程度。     

Impact of peripherally inserted central venous catheter-associated phlebitis in neonate guided by intracavitary electrocardiogram: A systematic review and meta-analysis of randomised controlled trials

Because the application of intracavitary electrocardiogram (IC-ECG)-guided peripherally inserted central catheter (PICC) in the treatment of neonates is controversial in terms of phlebitis reduction compared with traditional X-ray positioning technique, a systematical evaluation is needed on the impact of IC-ECG on this common complication following PICC. Literature retrieval was conducted on large databases including PubMed, Google Scholar, Cochrane library, and CNKI. Randomised controlled trials (RTCs) of intracavitary electrocardiogram-guided peripherally inserted central catheter tip placement in the treatment of neonates up to July 7, 2022, were collected. Then indicators of included studies were compared and analysed by two researchers. Meta-analysis was performed on the STATA 17.0 software. After excluding invalid trials, 11 out of 316 randomised controlled trials were included for further analysis. Meta-analysis results showed that compared with the control group, IC-ECG-guided PICC could decrease the incidence of phlebitis (I² = 0.00%, P = 0.76, OR = 0.33, 95% CI 0.19–0.56) and that no significant difference was observed between preterm neonates and term neonates (P = 0.74). Meanwhile, total complications were decreased in neonates (I² = 0.00%, P = 0.00 OR = 0.23, 95% CI 0.16–0.33). IC-ECG-guided PICC could also improve the accuracy of optimal tip location (I² = 0.00%, P = 0.53, OR = 5.37, 95% CI 3.80–7.59). IC-ECG-guided PICC could achieve reduced phlebitis incidence and total complications in the treatment of neonates, as well as increased accuracy of optimal tip location, no matter if those neonates were preterm or not. This study was registered in inplasy.com with No. INPLASY202280012 (DOI: 10.37766/inplasy2022.8.0012).