Wickham Rita, Engelking Constance, Sauerland Carmel, Corbi Dominick
College of Nursing, Rush University, Chicago, IL, USA.
Oncol Nurs Forum. 2006 Nov 27;33(6):1143-50. doi: 10.1188/06/ONF.1143-1150.
PURPOSE/OBJECTIVES: To review the literature, synthesize current recommendations, and discuss remaining controversies regarding vesicant extravasation management.
Published evidence-based reports, clinical articles, and anecdotal case reports about antineoplastic and nonantineoplastic vesicant agent management.
Prevention of vesicant extravasation sequelae requires knowledge about vesicant extravasation manifestations and differentiation of vesicant extravasation from other local IV site reactions. When evidence is weak or missing, logical application of data-based or empirical management strategies is critical. Actions may include timely administration of subcutaneous or topical antidotes, comfort measures, and surgical interventions to minimize the extent of tissue damage and morbidity should extravasation occur.
Vesicant extravasation and sequelae constitute a complex patient problem. Clinicians should strive to prevent extravasation or seek to minimize injury should it occur. To this end, clinicians must demonstrate awareness of its risks and use specialized knowledge when administering vesicant agents.
Nurses who administer vesicant agents should understand the nursing and collaborative actions that should be taken to minimize patient morbidity, pain, and disability.
目的/目标：回顾文献，综合当前建议，并讨论关于刺激性药物外渗处理的尚存争议。
已发表的循证报告、临床文章以及关于抗肿瘤和非抗肿瘤刺激性药物处理的个案报道。
预防刺激性药物外渗后遗症需要了解刺激性药物外渗的表现，以及区分刺激性药物外渗与其他局部静脉输液部位反应。当证据不足或缺失时，合理应用基于数据或经验的处理策略至关重要。措施可能包括及时给予皮下或局部解毒剂、舒适护理措施以及手术干预，以便在发生外渗时将组织损伤程度和发病率降至最低。
刺激性药物外渗及其后遗症构成一个复杂的患者问题。临床医生应努力预防外渗，或在发生外渗时尽量减少损伤。为此，临床医生在使用刺激性药物时必须意识到其风险并运用专业知识。
使用刺激性药物的护士应了解为将患者的发病率、疼痛和残疾降至最低而应采取的护理及协作措施。
