Abe-Doi Mari, Murayama Ryoko, Komiyama Chieko, Sanada Hiromi
Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Jpn J Nurs Sci. 2020 Jul;17(3):e12329. doi: 10.1111/jjns.12329. Epub 2020 Feb 9.
Following chemotherapy, induration may occur. This study was conducted to survey induration incidence and risk factors, and investigation for actual condition of induration.
A cohort study was conducted for survey of incidence and risk factors, and a cross-sectional observation study was conducted to examine actual condition of induration. The sites of chemotherapy administration were recorded, and these were observed on the next treatment day. Clinical nurses judged the presence or absence of induration by palpation. The sites were observed using ultrasonography. To investigate the risk factors associated with the induration, logistic regression analysis was performed using independent variables based on univariate analysis or previous reports.
In total, 69 patients were analyzed. The induration incidence was 17.4%, and three abnormal conditions were confirmed: subcutaneous edema, thrombosis, and thickening of the vessel wall. Breast cancer, non-vesicant drug, vein diameter, and fosaprepitant use were included in the logistic regression model. Breast cancer: odds ratio (OR) 9.25; 95 CI 1.91.-44.71; non-vesicant drug: OR 1.37; 95 CI 0.13-14.95; vein diameter: OR 0.40; 95% CI 0.16-0.97; fosaprepitant use: OR 0.16; 95% CI, 0.18-10.32.
The induration incidence was 17.4%. Risk factors for induration following chemotherapy administration were breast cancer and smaller vein diameter. Abnormal cases of subcutaneous tissue were confirmed, including subcutaneous edema, thrombosis, and thickening of the vessel wall. Induration may be prevented by selecting larger diameter vessels using ultrasonography when catheterizing for chemotherapy.
化疗后可能会出现硬结。本研究旨在调查硬结的发生率和危险因素,并对硬结的实际情况进行调查。
进行队列研究以调查发生率和危险因素,并进行横断面观察研究以检查硬结的实际情况。记录化疗给药部位,并在下次治疗日进行观察。临床护士通过触诊判断是否存在硬结。使用超声检查这些部位。为了调查与硬结相关的危险因素,基于单因素分析或先前报告的自变量进行逻辑回归分析。
总共分析了69例患者。硬结发生率为17.4%,确认了三种异常情况:皮下水肿、血栓形成和血管壁增厚。逻辑回归模型包括乳腺癌、非刺激性药物、静脉直径和福沙匹坦的使用。乳腺癌:比值比(OR)9.25;95%置信区间1.91.-44.71;非刺激性药物:OR 1.37;95%置信区间0.13-14.95;静脉直径:OR 0.40;95%置信区间0.16-0.97;福沙匹坦的使用:OR 0.16;95%置信区间,0.18-10.32。
硬结发生率为17.4%。化疗给药后硬结的危险因素是乳腺癌和较小的静脉直径。确认了皮下组织的异常情况,包括皮下水肿、血栓形成和血管壁增厚。化疗置管时使用超声选择较大直径的血管可能预防硬结。