Tighe M J, Wong C, Martin I G, McMahon M J
University Department of Surgery, General Infirmary, Leeds, United Kingdom.
JPEN J Parenter Enteral Nutr. 1995 Nov-Dec;19(6):507-9. doi: 10.1177/0148607195019006507.
The aim of this prospective, randomized study was to determine if the addition of heparin and hydrocortisone, and the application of a topical glyceryl trinitrate patch over the catheter site (triple therapy) would results in a reduced incidence of thrombophlebitis during i.v. nutrition through a peripheral vein. Forty-six patients were randomized to receive either standard i.v. nutrition (i.v.N)(1200 mosm/kg) (control group, n = 23), or i.v.N plus triple therapy (study group, n = 23). The patient's arm was examined daily, and the catheter was removed if signs of thrombophlebitis were evident. The two groups were well matched in terms of age and gender, as well as indication for feeding and total days of i.v.N supplied. The catheters in the study group survived longer (p < .0001), and resulted in a lower incidence of thrombophlebitis (p < .05). The time of onset of thrombophlebitis was delayed in the study group (p < .0001). It is recommended that heparin, hydrocortisone, and a glyceryl trinitrate patch should be administered to all patients receiving i.v. nutrition via a fine-bore peripheral catheter.
这项前瞻性随机研究的目的是确定在通过外周静脉进行静脉营养期间，添加肝素和氢化可的松以及在导管部位应用硝酸甘油贴剂（三联疗法）是否会降低血栓性静脉炎的发生率。46例患者被随机分为接受标准静脉营养（静脉营养）（1200 mosm/kg）（对照组，n = 23）或静脉营养加三联疗法（研究组，n = 23）。每天检查患者的手臂，如果有明显的血栓性静脉炎迹象，则拔除导管。两组在年龄、性别、喂养指征和提供静脉营养的总天数方面匹配良好。研究组的导管存活时间更长（p <.0001），血栓性静脉炎的发生率更低（p <.05）。研究组血栓性静脉炎的发病时间延迟（p <.0001）。建议对所有通过细孔径外周导管接受静脉营养的患者给予肝素、氢化可的松和硝酸甘油贴剂。
