The Experimental Study On Phlebitis Caused By Continuous Infusion Of Amiodarone Hydrochloride Injection Through Indwelling Needle

Objective:The infusion of amiodarone hydrochloride was performed by intravenous indwelling needle to observe the occurrence of intravenous phlebitis of rabbit ear vein,morphological changes of early phlebitis and the trend of C-reactive protein,and to explore the continuous infusion of amiodarone injection Time and the occurrence of phlebitis,for the clinical application of indwelling needle continued infusion of pH <5 similar to provide a theoretical reference.Methods:Through the investigation of clinical nursing work,the clinical practice of the high incidence of phlebitis in several commonly used drugs,by drug analysis and pH determination,the final determination of clinical commonly used in the treatment of arrhythmia treatment of amiodarone hydrochloride injection as Study of the drug,the pH value of 2.5-4.0,and various reasons Central venous catheter can not be implemented,the clinical practice of multi-purpose intravenous indwelling needle continued infusion.Choose healthy Japanese rabbits 60 adaptive feeding week later,follow the principle of completely randomly assigned into experimental group(amiodarone group)and control group(saline group),30 rats in each,then use completely random assignment Methods The experimental group and the control group were randomly divided into 5 groups,namely,1h group,2h group,3h group,4h group,5h group,each group of 6.This study is divided into two phases.The first stage: the right ear ear vein for the detection of rabbit C-reactive protein concentration of the experimental blood vessels,intravenous indwelling needle catheterization according to the group continued infusion(In the experimental group,refer to the recommended method of amiodarone hydrochloride injection.The dosage should be determined by the equivalent dose ratio between human and animal under the premise of ensuring the same concentration.That is,the administration of 8mg / kg In a 5% glucose solution in 5.33 ml / kg,the concentration of the drug was 1.5 mg / ml;followed by 6 mg /kg of 5 mg / kg in a 5% glucose solution at 11.11 ml / kg,the drug concentration was 1.8mg / ml.The control group continued infusion of saline,the drip rate of 40 drops /min).After 48 hours of infusion,2 ~ 3ml of blood was taken from the ear of the right ear and collected at room temperature for 30 min.After centrifugation,the supernatant was collected and the serum CRP concentration was measured by ELISA.After the extraction of venous blood,in the right ear outside the ear vein corresponding position smear Hirudoid ointment,and 50% sulphate gauze wet compress,30 min every day,even for 5 days,and then continue to adapt to feeding for 30 days.The second stage: 30 days later,with the left ear ear vein for continuous infusion of phlebitis after treatment of the experimental blood vessels,intravenous indwelling needle after catheterization according to their group continued infusion(the same dose),Infusion after intramuscular injection of serotonin hydrochloride injection(0.1 ~ 0.2ml / kg)anesthesia to take the living specimens.That is,puncture blood vessels as the center of the left and right sides of the width of 0.5cm,a total of 1cm,to puncture point as the mark point,far from the end of 0.5cm,near the heart to take 3.0cm,a total length of about 3.5cm rectangular specimens,fixed 24 h,conventional dehydration,paraffin embedding,each specimen were sliced 3,respectively,for the puncture point near the proximal end 0.5cm,indwelling needle tip and indwelling needle tip near the proximal end 0.5cm,HE stained by the professional disease The physician performs a light microscope.Results:1 The concentration of CRP in both groups showed an increasing trend with the increase of continuous infusion time,and the difference of CRP concentration at 4h was statistically significant(P <0.05).2 The inflammatory response of amiodarone group was higher than that of saline group at the same time(?2= 8.326,P <0.05),but there was no difference in thrombosis Statistical differences(P> 0.05).3 In the same group of three different sections,the two groups of specimens were the most severe inflammation at the tip of the indwelling needle,and the amiodarone group at the tip of the indwelling needle and the proximal end of the indwelling needle 0.5cm near the inflammatory response compared to the difference(?2 = 9.179,P <0.05).In the case of thrombosis,the rate of thrombosis was the highest at the tip of the amiodarone group,but the difference was not statistically significant(P> 0.05),the saline group Thrombosis.4 In the same group,the number of vessels with thrombosis gradually increased with the infusion time,and the pharyngeal inflammatory reaction was gradually increased with the infusion of venous inflammation and thrombosis at different times.(P <0.05).The degree of inflammatory response in the saline group was statistically significant(P <0.01),and no thrombosis was found in the saline group.Conclusion:1 The occurrence of phlebitis is related to the chemical properties of the imported drug.Infusion of pH <5 is an important factor in the development of phlebitis.2 The occurrence of phlebitis and indwelling for the mechanical stimulation of blood vessels,indwelling needle at the tip of the inflammatory response and thrombosis rate,vascular inflammation of the most serious degree.3 The incidence of phlebitis is related to the duration of continuous infusion,the longer the duration of continuous infusion,the more severe the degree of vascular inflammation.4 In the peripheral vein by the indwelling needle continued to lose amiodarone injection,the same intravenous infusion of the same time is generally 2h is appropriate,up to not more than 3h,if the duration of more than 3h,should be established 2 Above the intravenous access to the use of intravenous self-repair to provide adequate time,from the fundamental to the prevention of phlebitis.