Hecker J F
Department of Surgery, Royal Postgraduate Medical School, London, UK.
Br J Cancer. 1990 Oct;62(4):660-2. doi: 10.1038/bjc.1990.351.
Factors associated with the failure of intravenous infusions due to phlebitis and extravasation were studied with 218 infusions delivering cytotoxic drugs. The survival rate of these infusions was not significantly different from that of 56 non-cytotoxic infusions in oncology patients. Although survival analysis indicated that cisplatin was associated with longer survival, this was probably an artifact caused by this drug usually being preceded by 24 h prehydration. Multivariate analysis indicated that etoposide was the only drug associated with decreased infusion survival and that bleomycin, cyclophosphamide, doxorubicin, ifosphamide, methotrexate, treosulphan and 5-fluorouracil had no significant effects. Also age of patient, infusion site and flow rate had no effects but survival was shorter in women. Follow-up indicated that failure of an infusion tended to result in loss of the vein. It is suggested that irritancy of the large volumes of intravenous fluids given to hydrate these patients rather than the cytotoxic drugs was the main factor reducing the survival of these infusions.
对218例输注细胞毒性药物的静脉输液因静脉炎和外渗导致失败的相关因素进行了研究。这些输液的存活率与肿瘤患者56例非细胞毒性输液的存活率无显著差异。尽管生存分析表明顺铂与较长的存活时间相关，但这可能是一种假象，因为通常在使用该药物前会先进行24小时的水化。多变量分析表明依托泊苷是唯一与输液存活时间缩短相关的药物，而博来霉素、环磷酰胺、阿霉素、异环磷酰胺、甲氨蝶呤、苏消安和5-氟尿嘧啶无显著影响。此外，患者年龄、输液部位和流速也无影响，但女性的存活时间较短。随访表明输液失败往往会导致静脉丧失。提示给这些患者进行水化的大量静脉输液的刺激性而非细胞毒性药物是降低这些输液存活时间的主要因素。
