Mayo D J, Pearson D C
Critical Care/Heart, Lung and Blood and Cancer Nursing Service, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Oncol Nurs Forum. 1995 May;22(4):675-80.
PURPOSE/OBJECTIVES: To describe, using two case studies, chemotherapy drug extravasation as a consequence of fibrin sheath formation.
Journal articles, textbooks, medical records, and personal experiences.
Fibrin sheath formation around venous access devices (VADs) frequently leads to persistent withdrawal occlusion (PWO). While PWO often is easily managed with small doses of thrombolytic therapy (e.g., urokinase), it may result in a more serious complication, such as chemotherapy extravasation.
Chemotherapy should not be administered through a VAD unless a free-flowing blood return can be demonstrated.
Careful nursing assessment of all VADs is important to identify complications such as fibrin sheath formation. To rule out fibrin sheath formation, nurses must obtain catheter dye studies when fibrinolytic therapy fails to restore catheter function.
目的/目标：通过两个案例研究，描述因纤维蛋白鞘形成导致的化疗药物外渗情况。
期刊文章、教科书、医疗记录及个人经验。
静脉输液装置（VAD）周围纤维蛋白鞘的形成常导致持续性回血受阻（PWO）。虽然小剂量溶栓治疗（如尿激酶）通常能轻松处理PWO，但它可能导致更严重的并发症，如化疗药物外渗。
除非能证明回血顺畅，否则不应通过VAD进行化疗给药。
对所有VAD进行仔细的护理评估，对于识别诸如纤维蛋白鞘形成等并发症很重要。为排除纤维蛋白鞘形成，当溶栓治疗未能恢复导管功能时，护士必须进行导管造影检查。
