Clinical Study Of Preventive Interventions On Reducing The Incidence Of Phlebitis Caused By Drugs Such As Amiodarone Hydrochloride

Objective: To observe the effects of experimental group and the control group on the drug-related phlebitis,which contain the amiodarone hydrochloride,dopamine hydrochloride and isoprenaline hydrochloride.Methods: Inclusion criteria: 1)The patients who were hospitalized in the Department of Cardiology,Second Hospital of Hebei Medical University from January 2017 to October 2017 were selected;2)The willingly injected with one of amiodarone hydrochloride,dopamine hydrochloride,and isoprenaline hydrochloride patients were taken part in this study;3)The patient didn`t have phlebitis before hospitalization or before medication.Exclusion criteria:1)age less than 18 years;2)the patients with skin diseases,autoimmune diseases,acute and chronic infectious diseases,allergies,scars,blood diseases,body temperature> 37.5 °C,malignant tumors,severe liver and kidney insufficiency,and peripheral vascular disease such as arteriosclerosis obliterans,thromboangiitis obliterans,polyarteritis,arterial aneurysm,Raynaud’s disease,erthromelalgia,deep venous valve dysfunction,varicose vein of lower limb,telangiectasis,superficial thrombophlebitis,Budd-Chiari syndrome,arteriovenous fistula and so on;3)the patients who injected over one drug should be excluded.This study used open sequential design and ultimately selected 240 patients following inclusion and exclusion criteria.Each drug was divided into experimental group and control group(40 cases in the experimental group and the control group),the experimental group was given preventive intervention measures added general care,and the control group was given general care.Prevention interventions: The interventions proposed on the basis of the “etiology hypothesis” of three drugs-induced phlebitis include: lowering the infusion concentration of the three drugs,using a precision infusion set for infusion,formulating an improved treatment process by the etiological hypothesis and education before and after treatment.Both of the above measures are performed by unified training and qualified operation nurses(Fig.1-3).Criteria for the determination of phlebitis refers to the 2006 version of the American Institute for Intravenous Nursing(INS)intravenous care practice.All the data were collated by establish Microsoft Excel database,and the statistical analysis proformed using SPSS 17.0 software.Measurement data with normality were expressed as mean±standard deviation,otherwise as the quartile method.The t-test or chi-square test was used for comparison between the two groups.Comparison of the incidence of different grades of phlebitis in two groups using rank sum test.P<0.05 was considered statistically significant.Results:1.There is no difference in age,gender,and underlying disease between the two groups.There were 41 cases of phlebitis in the experimental group,and the incidence was 34.17%.In the control group,there were 86 cases of phlebitis and the incidence rate was 71.67%.The incidence of phlebitis in the experimental group was lower than that in the control group(P<0.05)(Fig.4).2.Effect of prevention intervention on occurrence of phlebitis caused by amiodarone hydrochloride and CRP and IL-6The incidence of phlebitis was 32.50% in the experimental group and 72.50% in the control group.The difference was statistically significant(P<0.05).The average time of occurrence of phlebitis in the experimental group was(5.2±1.6)days;the control group was(3.9±1.5)days.At the end of treatment,CRP was(17.5±6.8)mg/L and IL-6 was(0.21±0.07)ng/ml in the experimental group;CRP was(22.2±6.4)mg/L and IL-6 was(0.26±0.08)ng/ml in the control group.There were significant differences in the time of phlebitis and CRP and IL-6 levels between the two groups(all P<0.05)(Fig.5-7,Table1).3.Effect of prevention intervention on occurrence of phlebitis caused by dopamine hydrochloride and CRP and IL-6The incidence of phlebitis was 35.00% in the experimental group and 72.50% in the control group.The difference was statistically significant(P<0.05).The average time of occurrence of phlebitis in the experimental group was(5.1±1.9)days;the control group was(3.8±1.8)days.At the end of treatment,CRP was(17.3±5.9)mg/L and IL-6 was(0.19±0.08)ng/ml in the experimental group;CRP was(21.5±10.1)mg/L and IL-6 was(0.26±0.10)ng/ml in the control group.There were significant differences in the time of phlebitis and CRP and IL-6 levels between the two groups(all P<0.05)(Fig.8-10,Table2).4.Effect of prevention intervention on occurrence of phlebitis caused by isoprenaline hydrochloride and CRP and IL-6The incidence of phlebitis was 35.00% in the experimental group and 70.00% in the control group.The difference was statistically significant(P<0.05).The average time of occurrence of phlebitis in the experimental group was(5.0±1.6)days;the control group was(3.8±1.4)days.At the end of treatment,CRP was(18.1±6.5)mg/L and IL-6 was(0.25±0.09)ng/ml in the experimental group;CRP was(30.6±12.1)mg/L and IL-6 was(0.31±0.09)ng/ml in the control group.There were significant differences in the time of phlebitis and CRP and IL-6 levels between the two groups(all P<0.05)(Fig.11-13,Table3).Conclusion:.1.Prevention intervention measures can reduce the irritating amiodarone,dopamine and isoprenaline-associated phlebitis in cardiology and reduce the levels of inflammatory factors CRP and IL-6.2.Prevention intervention measures can prolong the occurrence of irritant amiodarone,dopamine and isoprenaline-associated-associated phlebitis in cardiology.