经锁骨下静脉穿刺与外周浅静脉注射长春瑞宾安全性对比

目的 :减少长春瑞宾 (NVB)静脉化疗的局部毒性 ,探讨锁骨下静脉化疗安全性 ,并与外周浅静脉化疗方法进行比较。方法 :对 81例接受NVB化疗的患者分为两组 ,A组为锁骨下静脉穿刺置管滴注组 (4 0例 ,共接受NVB注射 16 0次 ) ,B组为外周浅静脉穿刺滴注 (4 1例 ,共 16 4次 )。NVB以 4 0～ 5 0mg稀释于 0 .9%氯化钠 10 0～ 15 0ml中 ,10 0～ 12 0滴·min- 1 速度滴注 ,再以同样的速度滴入 0 .9%氯化钠 10 0～ 2 5 0ml。结果 :A、B两组局部静脉炎发生率分别为 0和 18.2 9%(30 16 4次 ) ;局部疼痛为 5 %和 19.5 %;输液外漏为 0和 7.32 %,差异有显著性 (P <0 .0 5 )。穿刺部位感染为 7.5 %(3 4 0 )和 0 (0 4 1) ,穿刺部位出血为 2 .5 %和 5 .4 8%;治疗后病人接受率为 10 0 %(4 0 4 0 )和 70 .73%(2 9 4 1)。结论 :用锁骨下静脉穿刺置管方法可杜绝NVB的局部毒性和输液外漏 ,但值得注意的是 ,该方法有一定的穿刺部位感染发生率。

Reliability Comparison between Vinorelbine Injected through Subclavian Vein Puncture and through Forearm Superficial Vein

Objective: To explore the reliability of vinorelbine(NVB) injected by superficial vein,and to compare the method of foream superficial vein and of subclavian vein. Methods: 81 patients accepted vinorelbin were divided into two groups,Group A was injected vinorelbine by subclavian vein(40 cases,160 times injected NVB), Group B was by forearm superficial vein(41 cases,164 times injected NVB). 40～50 mg of NVB plus 100～150 ml 0.9% saline were injected with velocity of 100～120 gtt·min -1 and then injected 0.9% saline 100～250 ml with same velocity. Results: The incidence on phlebitis was 0 in Group A and 18.29%(30/164 times) in Group B,on local pain in puncture locus was 5%(3/40 cases) in Group A and 19.5% in Group B,on transfuse leakage was 0 in Group A and 7.32 % in Group B,P<0.05,these difference was significant on statistics. The incidence on infestation of puncture locus was 7.5% in Group A and 0% in Group B and on bleeding in puncture locus was 2.5% and 5.48%. Acceptance rate was 100% in Group A after treatment and 70.3% in Group B. Conclusion: The method of injecting NVB through subclavian vein could prevent local vein toxicity of NVB and prevent leakage. But this method have a few of infection incidence in puncture locus and haemorrhea, pneumothorax and air embolism may happen.