目的:观察康惠尔透明贴防治表阿霉素(E--ADM)联合用药致静脉炎的临床效果。方法:将160名第1次大剂量(100mg／m2)静脉滴注表阿霉素的乳腺癌术后患者按床号的单双数随机分为对照组和实验组各80例,静脉穿刺处对照组使用3M透明贴,实验组使用康惠尔透明贴,观察两组患者静脉炎发生率及严重程度。结果:对照组发生静脉炎31例,实验组发生静脉炎9例。两组经秩和检验,W=6.638 P=0.0353。 结论:使用康惠尔透明贴能有效预防表阿霉素联合用药所致的静脉炎,值得临床推广应用。
Objective To formulate a rational adjuvant therapeutic evidence-based nursing plan for a patient with grade II red and swelling type phlebitis. Methods According to the condition of the patient and using the PICO principle, we put forward clinical problems. Then we comprehensively searched the National Guideline Clearinghouse (NGC), ACP Journal Club, The Cochrane Library, DARE, PubMed, MEDLINE, CNKI and Google Scholar from 2000 to 2012. Relevant clinical guidelines, evidence summaries, systematic reviews/ meta-analyses, randomized controlled trials (RCTs), and high quality reviews on adjuvant therapy of grade II red and swelling type phlebitis were collected and their authenticity, importance and applicability were evaluated. Results One systematic review, four meta-analyses, five RCTs, and one review were totally included. According to current evidence as well as the patient’s clinical conditions and preference, a comprehensive and effective adjuvant therapeutic and nursing programme was given to the patient. For grade II red and swelling type phlebitis with blisters and severe pain, paretic infusion should be immediately stopped on the lesion-side limb, and venous indwelling needle should be extracted. Then, mucopolysaccharide polysulfate cream should be applied on the skin impaired by vein inflammation, and the local area should be gently massaged for 3 min, twice daily (once in the morning and evening, respectively). After four-day treatment and nursing care, the patient with phlebitis had already recovered. Conclusion Evidence-based medicine approaches could help us develop comprehensive therapeutic plans for patients which promote recovery of patients with phlebitis, alleviate pain, improve health, and increasepatients’ quality of life.
ObjectiveTo systematically review the effect of pre-treating the catheters with dexamethasone for preventing PICC-associated phlebitis. MethodsWe electronically searched PubMed, EMbase, The Cochrane Library (Issue 4, 2012), CNKI, CBM, WanFang Data and CQVIP for studies about pre-treating the catheters with dexamethasone to prevent PICC-associated phlebitis from inception to March 2013. Relevant studies including grey literature were also manually searched. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of the included studies. Then meta-analysis was performed using the software RevMan 5.0. ResultsA total of 13 studies involving 1 965 cases (1 025 cases in the dexamethasone group, and 940 cases in the control group) were included. The results of meta-analysis showed that pre-treating the catheters with dexamethasone could significantly decrease the incidence of PICC-associated phlebitis (RR=0.29, 95%CI=0.22 to 0.39, P < 0.000 1). However, no significant difference was found for the PICC-associated other complications, such as pipe blockage, bleeding, swelling of puncture site, allergy and atopic catheter. ConclusionPre-treating the catheters with dexamethasone soltion before inserting could reduce the incidence of PICC-associated phlebitis. The aforementioned conclusion needs to be further validated by more high-quality and large-scale randomized controlled trials.
ObjectiveTo investigate the effectiveness of hydrocolloid dressing in preventing peripheral phlebitis due to intravenous infusions. MethodsFrom April 1st to October 30th, 2014, 320 patients admitted in the Biliary Department of West China Hospital for parenteral nutrition were collected along with their clinical data and were randomly divided into control group and intervention group. A total of 160 patients who were allocated in the control group accepted simple dressing with 3M adhesive tape (6 cm×7 cm) at the intravenous catheter site. In contrast, hydrocolloid dressing (5 cm×7 cm) was applied at the intravenous catheter site and then covered with 3M adhesive tape (6 cm×7 cm) for the patients in the intervention group. ResultsPhlebitis rate was significantly higher in the control group (115 patients) than that in the interventions group (64 patients) (χ2=32.978, P<0.001). In addition, the severity of phlebitis was higher in the control group than that in the intervention group (Z=-4.466, P<0.001). Statistically significant difference was noted. ConclusionHydrocolloid dressing is effective in preventing and delaying the occurrence of peripheral phlebitis due to intravenous infusions.
Objective To analyze the association of human leucocyte antigen (HLA)-DRB and -DQB alleles with Ealesprime; disease, and to investigate the potential immunogenetics mechanism of Ealesprime; disease. Methods Gene loci of HLA-DRB and -DQB1 alleles were detected by polymerase chain reaction-sequence specific primer (PCR-SSP) in 27 Han-nationality patients with Ealesprime; disease in Northern China and 30 age and sex-matched normal persons as control, then statistics package for social science (SPSS) for Windows ver 13.0 software was used to analyze the distribution features of frequency of HLA-DRB and -DQB1 alleles in the two groups. Results Compared with the control group, the frequency of HLA-DRB104 allele increased obviously in the patients with Ealesprime; disease［odds ratio (OR)=3.20 ，OR 95% confidence interval（CI）=1.00-10.21, and P=0.047］. Simultaneously, no statistically significant difference of the distribution of any other DRB or DQB1 allele between the two groups was found (Pgt;0.05). Conclusions In hannationality people in Northern China, DRB104 is positively associated with Ealesprime; disease, suggesting that DRB104 may confer a major influence on Ealesprime; disease. Turbulence of immune function begotten by infect-agents attack may occur in the individuals with Ealesprime; disease due to the specific hereditary diathesis of HLA, which may cause the occurrence and development of Eales disease. (Chin J Ocul Fundus Dis, 2006, 22: 90-93)