Nordenström J, Jeppsson B, Lovén L, Larsson J
Department of Surgery, Huddinge University Hospital, Sweden.
Br J Surg. 1991 Nov;78(11):1391-4. doi: 10.1002/bjs.1800781140.
The incidence and severity of infusion phlebitis was evaluated prospectively in 142 surgical patients who received peripheral parenteral nutrition (PPN) for a total of 700 days. In a first study phase 83 patients were given PPN for a total of 424 days. All nutrient solutions were delivered over a 12-h period from a 3-litre bag and the infusion sites rotated daily. These methods resulted in an incidence of phlebitis of 18 per cent, 75 per cent of the patients being fed successfully by PPN until resumption of oral nutrition. In an attempt to assess the importance of the method of delivering nutrient solutions, the next 59 patients were randomized to receive PPN as a compounded mixture or by a conventional technique with simultaneous infusion from separate bottles. Infusion phlebitis was significantly more frequent (P less than 0.001) in patients infused with separate bottles. There was no difference between the groups with regard to duration of nutrition or the need to establish central venous access. We conclude that PPN is a safe and cost-effective means of providing total parenteral nutrition in most surgical patients. The use of compounded mixtures significantly reduces the incidence of phlebitis without increasing total costs.
前瞻性评估了142例接受外周肠外营养（PPN）共700天的外科患者输注性静脉炎的发生率和严重程度。在第一个研究阶段，83例患者接受PPN共424天。所有营养液均在12小时内从一个3升袋中输注，输注部位每天更换。这些方法导致静脉炎发生率为18%，75%的患者通过PPN成功喂养直至恢复口服营养。为了评估营养液输注方法的重要性，接下来的59例患者被随机分为接受复合混合液或传统技术（从不同瓶子同时输注）的PPN。使用不同瓶子输注的患者中，输注性静脉炎明显更频繁（P<0.001）。两组在营养持续时间或建立中心静脉通路的需求方面没有差异。我们得出结论，PPN是大多数外科患者提供全肠外营养的一种安全且具有成本效益的方法。使用复合混合液可显著降低静脉炎的发生率，而不会增加总成本。
