湿润烧伤膏联合利多卡因对华蟾素所致静脉损伤的干预效果

尹秀芬+李铂+谭李军

【摘要】目的探讨湿润烧伤膏联合利多卡因对华蟾素所致静脉损伤的干预效果。

方法将经外周静脉输注华蟾素注射液的124例肝癌患者随机分为两组，每组62例。对照组采用常规静脉输液滴注方法，实验组则在静脉穿刺成功后，静脉滴注华蟾素前使用湿润烧伤膏沿静脉走向均匀涂抹于皮肤处，每日2～3次，并用2%利多卡因浸湿纱布以不滴液为宜，外敷输液静脉近心端约10 cm，直至输完华蟾素后2小时。

结果实验组在滴注速度<40滴/min、局部皮肤发红、外渗等方面所占比例明显低于对照组，差异有统计学意义（P<0001）；实验组疼痛发生率为21.0%，明显低于对照组的96.8%（P<0001）；两组疼痛分级比较差异有统计学意义（P<0001）。

结论 湿润烧伤膏联合利多卡因在华蟾素静脉滴注所致的滴注速度减慢、局部皮肤发红、外渗及减轻疼痛等方面有明显疗效，可显著降低华蟾素对血管的刺激，减少静脉损伤。

【关键词】静脉损伤；华蟾素；湿润烧伤膏；利多卡因

中图分类号：R473文献标识码：ADOI：10.3969/j.issn.10031383.2014.05.007

【Abstract】ObjectiveTo investigate the intervention effect of moisture exposed burn ointment （MEBO） combined with lidocaine on venous injury caused by cinobufacini injection.

Methods124 patients with liver cancer，who were injected with cinobufacini injection by peripheral vein，were randomly divided into experimental group and control group with 62 cases in each group.The control group were given conventional intravenous infusion.For the experimental group，however，after successful venipuncture，MEBO was evenly smeared over the skin along the vein for 2 or 3 times a day before using cinobufotalin by intravenous drip.Moreover，gauze soaked with 2% of lidocaine was externally applied on the skin about 10 cm from the infusion vein until the cinobufacini intravenous drip was finished for 2 hours.

Results Proportion of infusion rate<40 drops/min，local redness and exosmosis of skin in the experimental group was significantly lower than that in the control group，so the difference was statistically significant（P<0001）.Incidence of pain in experimental group was 21%，significantly lower than that（96.8%） in the control group（P<0001）.Difference in pain grading of two groups was statistically significant（P<0001）.

ConclusionMEBO combined with lidocaine has an obvious effect on slow dripping speed，local redness and exosmosis of skin，and pain abatement caused by intravenous drip of cinobufotalin.It can significantly decrease stimulation of cinobufotalin on blood vessel， and reduce venous injury.

【Key words】venous injury；cinobufotalin；MEBO；lidocaine

华蟾素注射液是近十余年受到高度重视的抗肿瘤中药制剂，临床上广泛应用于晚期恶性肿瘤的治疗[1]，但因静脉滴注后常出现局部红、肿、疼痛，输液速度减慢等血管刺激症状[2]。因此在临床应用过程中应加强防护，避免或减轻华蟾素所致的静脉损伤，使患者坚持治疗是临床护理的重点[3]。2011年6月至2013年12月，我们对62例肝癌患者在输注华蟾素过程中采用湿润烧伤膏联合利多卡因湿敷，效果满意，现报告如下。……