Servizio di Dietetica e Nutrizione Clinica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Service de Médecine Gériatrique, Centre Hospitalier Régional Universitaire and Université François Rabelais, Tours, France.
JPEN J Parenter Enteral Nutr. 2018 Feb;42(2):296-307. doi: 10.1177/0148607116676593. Epub 2017 Dec 20.
Subcutaneous infusion, or hypodermoclysis, is a technique whereby fluids are infused into the subcutaneous space via small-gauge needles that are typically inserted into the thighs, abdomen, back, or arms. In this review, we provide an overview of the technique, summarize findings from studies that have examined the use of subcutaneous infusion of fluids for hydration or nutrition, and describe the indications, advantages, and disadvantages of subcutaneous infusion. Taken together, the available evidence suggests that, when indicated, subcutaneous infusion can be effective for administering fluids for hydration or nutrition, with minimal complications, and has similar effectiveness and safety to the intravenous route. Of note, subcutaneous infusion offers several advantages over intravenous infusion, including ease of application, low cost, and the lack of potential serious complications, particularly infections. Subcutaneous infusion may be particularly suited for patients with mild to moderate dehydration or malnutrition when oral/enteral intake is insufficient; when placement of an intravenous catheter is not possible, tolerated, or desirable; at risk of dehydration when oral intake is not tolerated; as a bridging technique in case of difficult intravenous access or catheter-related bloodstream infection while infection control treatment is being attempted; and in multiple settings (eg, emergency department, hospital, outpatient clinic, nursing home, long-term care, hospice, and home).
皮下输液，又称皮下滴注，是一种通过小口径针头将液体输注到皮下组织的技术，通常将针头插入大腿、腹部、背部或手臂。在这篇综述中，我们概述了该技术，总结了检查皮下输注液体用于补液或营养的研究结果，并描述了皮下输注的适应证、优点和缺点。总的来说，现有证据表明，在有指征的情况下，皮下输注可以有效地进行补液或营养，并发症极少，与静脉途径的效果和安全性相当。值得注意的是，与静脉输注相比，皮下输注具有多项优势，包括易于操作、成本低、且潜在严重并发症（尤其是感染）的风险较低。当口服/肠内摄入不足时，皮下输注特别适合轻度至中度脱水或营养不良的患者；当无法、不能耐受或不希望放置静脉导管时；当不能耐受口服摄入时存在脱水风险时；在尝试控制感染治疗的同时，作为静脉通路困难或导管相关血流感染的桥接技术；以及在多种情况下（例如急诊科、医院、门诊、疗养院、长期护理、临终关怀和家庭）。
