摘要
目的探讨过敏性紫癜患者并发外周静脉留置针相关严重静脉炎的临床特点。方法选取2011年9月—2012年5月我院收治的过敏性紫癜腹型患者23例为研究对象,常规使用BD Saf-T-Intima 22 GA/24 GA或BD Inti-ma 22 GA/24 GA外周浅静脉留置针建立外周静脉输液通道,在穿刺成功后严格按留置针使用规范进行常规护理。结果23例过敏性紫癜患者中5例在成功建立外周静脉留置针通道开始静脉输液治疗24 h内,出现留置针穿刺部位周围3～4级红肿型或硬结性严重静脉炎,最大直径(7.1±3.6)cm。外周静脉留置针相关严重静脉炎发生率为22%。5例患者后续的静脉输液治疗通过对侧肢体使用钢针建立静脉输液通道继续完成,共使用钢针建立静脉通道36例次,并发穿刺部位1～2级静脉炎2例次(6%),更换输液部位继续完成治疗方案,无3～4级严重静脉炎发生。并发静脉炎后立即拔针并停止在患侧肢体输液,24 h内用硫酸镁湿冷敷,24 h后局部外擦多磺酸粘多糖乳膏等。5例患者严重静脉炎呈自限性,3～7 d急性期明显缓解,进入愈合期。结论过敏性紫癜治疗初期应用外周静脉留置针易并发严重静脉炎,换用钢针静脉通道和合理治疗静脉炎,随着过敏性紫癜的缓解而渡过急性期。
Objective To analyze the clinical features of detained peripheral intravenous catheter associated severe phlebitis in allergic purpura patients. Methods A total of 23 patients with allergic purpura admitted from September 2011 to May 2012 in our department were retrospectively collected and analyzed. All of them were given BD Saf- T - Intima 22 GA/24 GA or BD Intima 22 GA/24 GA for peripheral intravenous access, and then all of them were given routine nursing after punc- ture. Results Five cases out of the 23 had severe phlebitis [ maximum diameter of （7.1±3.6） cm] at puncture site of detained catheter during the first 24 h, and the incidence of severe phlebitis was 22%. The venous transfusion of the five patients was con- tinued by establishing transfusion path for 36 case times by using steel needle in offside limb. There were 2 case （6%） times of phlebitis in the puncture site. After changing the transfusion site before finishing the treatment, no severe phlebitis was found. After finding phlebitis, the needle was withdrawn and the transfusion in the offside limb was suspended. Magnesium sulfate was used for cold moist compress within 24 h, and mucopolysaccharide polysulfat~ cream was used for external application after 24h. The phlebitis showed selfconfinement in the five cases and it was significantly improved in the 3 ~ 7 days before entering into healing phase. Conclusion Applying detained peripheral intravenous catheter in the beginning period of allergic purpura is the independent risk factor for severe phlebitis. When alternating to steel needle access and proper treatment, severe phlebitis is self - limiting and alleviated along with the palliation of allergic purpura.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第15期1771-1773,共3页
Chinese General Practice
基金
四川省卫生厅科研课题项目(120223)
关键词
紫癜
过敏性
留置针
静脉炎
Purpura, Sehoenlein - Henoch
Indewelling needle in vein
Phlebitis
