成人周邊靜脈管路引起之靜脈炎相關因素探討－－系統性回顧

The Related Factors on Phlebitis of Peripheral Intravenous Catheter on Adults--A Systematic Review

周邊靜脈點滴注射是一項最常見的侵入性治療，故維護周邊靜脈注射管路為一重要議題；但臨床上，靜脈注射管路常因靜脈炎之關係，必須移除管路重打及照護靜脈炎的部位。本文以系統性回顧的方式，希望在已發表的文章中，整理出哪些臨床變項為成人周邊靜脈炎發生的相關因素。由Scopus、Cochrane、Elseiver Science Direct、Blackwell Synergy、Pubmed、CINAHL、Proquest Medical Library、思博網(Ceps)之中文期刊等資料庫，搜尋文獻。結果發現：靜脈導針留置時間與靜脈炎有關，且留置時間越長發生靜脈炎之機率越高；而靜脈導針大小並非影響周邊靜脈管路是否發生靜脈炎之因素。結論及建議：其餘變項，則因結果皆不一致（如：性別、靜脈導針大小方面、靜脈點滴使用的原因、靜脈導針注射的解剖位置、在注入靜脈導針的人員方面、年齡及診斷）或僅為單一研究之結果，證據力較低，建議未來研究應朝此方向努力，證明這些因素是否與周邊靜脈管路發生靜脈炎有關，並指出未來研究設計，應觀察靜脈注射流程﹔同時，在靜脈導針留置時間及病患年齡方面，建議分別以留置小時及將年齡以連續變項執行資料分析，則將獲得更精確結果。

Peripheral intravenous injection is the most commonly used invasive treatment, therefore, maintaining the peripheral intravenous catheters is an important issue. Phlebitis of the peripheral intravenous catheters will lead to removal of the peripheral intravenous catheters and the need of taking care of the part of the phlebitis. This systemic review was to investigate the related factors on phlebitis of peripheral intravenous catheters of adults. The literatures were searched in the following eight online electronic databases: Scopus, Cochrane, Elseiver Science Direct, Blackwell Synergy, Pubmed, CINAHL, Proquest Medical Library, and Chinese Ceps databases. The reviews showed that the longer the indwelling time was, the higher possibility of phlebitis there was. Other variables, such as, genders, catheter sizes, reasons for use of peripheral intravenous catheters, anatomic locations, the persons of venipuncture, ages, and diagnoses, were inconsistently associated with the conditions. Therefore, the level of evidence was low. Future studies could verify these inconsistent findings and investigate variables such as venipuncture procedures, etc. Indwelling time of catheters and age of the patients could be analyzed as continuous variables to improve precision.