Arias-Fernández Loreto, Suérez-Mier Belén, Martínez-Ortega María Del Carmen, Lana Alberto
Servicio de Medicina Preventiva, Hospital Universitario Central de Asturias, Oviedo, España; Departamento de Medicina, Área de Medicina Preventiva y Salud Pública, Universidad de Oviedo, Oviedo, España.
Servicio de Medicina Preventiva, Hospital Universitario Central de Asturias, Oviedo, España.
Enferm Clin. 2017 Mar-Apr;27(2):79-86. doi: 10.1016/j.enfcli.2016.07.008. Epub 2016 Sep 16.
To determine the incidence and risk factors of phlebitis associated to the care of peripheral vascular catheters (PVC).
Prospective cohort study at the Central University Hospital of Asturias (Spain). A total of 178PVC were observed daily until their extraction. The incidence of phlebitis was measured using the Visual Infusion Phlebitis Scale, that distinguishes between gradei (possible phlebitis) andii (phlebitis). The independent diagnoses of phlebitis made by staff nurses were also collected. Finally, data about the insertion and the care of the PVC was also obtained. The incidence of phlebitis and the validity of the diagnoses made by staff nurses were calculated and the risk factors of phlebitis were determined by means of logistic regression.
5.6% of the PVC presented phlebitis, 21.3% possible phlebitis and 11.2% had phlebitis according to nurses' criteria. The staff nurses had a sensitivity of 100%, a specificity of 94% and a positive predictive value of 50% in the diagnosis of phlebitis. After adjusting for potential confounders, the use of an extension tube as an accessory of the PVC was an independent predictor of phlebitis (odds ratio: 4.8; P=.04), but a PVC size of 22/24 gauges was associated with lower phlebitis incidence (odds ratio: 0.2; P=.02).
Clinical phlebitis assessment is difficult because the agreement for phlebitis diagnosis is low. To minimize the incidence of phlebitis would be recommended to choose the smallest PVC size possible and to avoid using an extension tube as an accessory of the PVC.
确定与外周血管导管（PVC）护理相关的静脉炎的发生率及危险因素。
在西班牙阿斯图里亚斯中央大学医院进行前瞻性队列研究。每天观察总共178根PVC，直至其拔除。使用视觉静脉炎量表测量静脉炎的发生率，该量表区分I级（可能的静脉炎）和II级（静脉炎）。还收集了注册护士对静脉炎的独立诊断。最后，获取有关PVC插入和护理的数据。计算静脉炎的发生率以及注册护士诊断的有效性，并通过逻辑回归确定静脉炎的危险因素。
根据护士的标准，5.6%的PVC出现静脉炎，21.3%可能出现静脉炎，11.2%有静脉炎。注册护士在静脉炎诊断中的敏感性为100%，特异性为94%，阳性预测值为50%。在对潜在混杂因素进行校正后，使用延长管作为PVC的附件是静脉炎的独立预测因素（比值比：4.8；P = 0.04），但22/24规格的PVC与较低的静脉炎发生率相关（比值比：0.2；P = 0.02）。
临床静脉炎评估困难，因为静脉炎诊断的一致性较低。为尽量减少静脉炎的发生率，建议选择尽可能小的PVC尺寸，并避免使用延长管作为PVC的附件。
