Becherucci A, Bagilet D, Marenghini J, Diab M, Biancardi H
Servicio de Clínica Médica, Sanatorio Delta, Rosario, Argentina.
Med Clin (Barc). 2000 Mar 18;114(10):371-3. doi: 10.1016/s0025-7753(00)71300-5.
Until present time, suggested treatments for superficial thrombophlebitis induced by intravenous infusion (TFSI), are of uncertain effectiveness and most of them or empirical and not fully researched. The aim of this report is to study the effectiveness and safety of the topical and oral administration of diclofenac in the treatment of TFSI.
In this prospective study 120 patients both female and male were included. All of them developed TFSI during hospitalization and at the same time they were assigned at random to one of the following groups: G-control (n = 40), without treatment; G-topical (n = 40), diclofenac emulsion gel used in a topical way on the concerned area every 8 hours during 48 hours; G-oral (n = 40), diclofenac 75 mg p.o. every 12 hours during 48 hours. The measurements were done at the moment of diagnosis of TFSI (T0) and 48 hours later (T2). Registries of intensity of TFSI were done by quantifying flushing, tumor, heatness and pain. These data were compared considering the averages of differences registered in T2 with respect to T0. A decrease of intensity of TFSI > or = 30% was considered a positive answer to this treatment. The quantitative variables were studied with ANOVA, Kruskal-Wallis test or general linear model and the qualitative with the chi 2 test with Yates correction. The level of significance used was alpha = 0.05.
The averages of differences in the intensity of TFSI that were registered in the groups G-control, G-topical and G-oral in T2 compared to T0 are: -0.12 (4.89), -5.70 (3.13), -4.82 (3.14) (p = 0.000). The favorable answers in G-control, G-topical and G-oral were: 20, 60 and 60%, respectively (p = 0.0001). The adverse reactions in G-topical and G-oral were: headache 9-5 (p = 0.2), epigastric pain 4-17 (p = 0.0009), nausea 6-16 (p = 0.01) and local pruritus 5-2 (p = 0.2). The treatment did not report serious adverse reactions in either of the groups.
The topical treatment of diclofenac can be recommended as an alternative simple, effective and safe therapy for patients who develop TFSI.
迄今为止,对于静脉输注所致浅表血栓性静脉炎(TFSI)的推荐治疗方法,其有效性尚不确定,且大多数方法为经验性的,未得到充分研究。本报告的目的是研究双氯芬酸局部和口服给药治疗TFSI的有效性和安全性。
在这项前瞻性研究中,纳入了120名男女患者。他们均在住院期间发生了TFSI,同时被随机分配到以下组之一:G-对照组(n = 40),不进行治疗;G-局部用药组(n = 40),在48小时内每8小时在相关区域局部使用双氯芬酸乳胶凝胶;G-口服组(n = 40),在48小时内每12小时口服75毫克双氯芬酸。在TFSI诊断时(T0)和48小时后(T2)进行测量。通过量化潮红、肿块、发热和疼痛来记录TFSI的强度。考虑到T2相对于T0记录的差异平均值来比较这些数据。TFSI强度降低≥30%被认为是对该治疗的阳性反应。定量变量采用方差分析、Kruskal-Wallis检验或一般线性模型进行研究,定性变量采用Yates校正的卡方检验。使用的显著性水平为α = 0.05。
与T0相比,G-对照组、G-局部用药组和G-口服组在T2记录的TFSI强度差异平均值分别为:-0.12(4.89)、-5.70(3.13)、-4.82(3.14)(p = 0.000)。G-对照组、G-局部用药组和G-口服组的有效反应分别为:20%、60%和60%(p = 0.0001)。G-局部用药组和G-口服组的不良反应为:头痛9 - 5(p = 0.2)、上腹部疼痛4 - 17(p = 0.0009)、恶心6 - 16(p = 0.01)和局部瘙痒5 - 2(p = 0.2)。两组均未报告严重不良反应。
对于发生TFSI的患者,双氯芬酸局部治疗可作为一种简单、有效且安全的替代疗法推荐。