Ultrasonographic assessment of an induration caused by extravasation of a nonvesicant anticancer drug A case report
Ultrasonographic assessment of an induration caused by extravasation of a nonvesicant anticancer drug A case report
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DOI：
10.1097/md.0000000000015043
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发表时间：
2019-04-01
期刊：
影响因子：
1.6
通讯作者：
Sanada, Hiromi
中科院分区：
文献类型：
--
作者：
Abe-Doi, Mari;Murayama, Ryoko;Sanada, Hiromi
基本原理：在反复接受化疗的患者中，由于减少了用于插入外周静脉导管的适当静脉的选择，导致导管放置困难，因此在抗癌药物外渗后可能发生硬结。虽然硬结影响治疗，但其大小、形状或硬度在传统的触诊和检查观察方法中仍不清楚。在这里，我们报告我们的观察结果，使用超声检查，以评估后发生的硬结的抗癌药物外渗作为一种新的评估方法。患者关注：一名58岁的妇女与宫颈癌谁抱怨疼痛的非发泡剂抗癌药物通过外周静脉导管管理。医护人员检查发现肿胀部位，更换导管，诊断：外渗后部位硬结。6个月后，色素沉着和硬结，这可以很容易地通过触诊证实，持续存在。干预：使用超声（B型和弹性成像）观察硬结部位的皮下组织。结果：皮下组织可能使静脉周围的组织变性，使其变薄。此外，皮下组织的硬度约为周围组织的7倍。教训：应预防影响静脉形态及其周围组织的硬结，超声检查是客观观察外渗部位的有效方法。
Rationale: Induration may occur after an anticancer drug extravasation in patients who recurrently receive chemotherapy because of reduced choice of an appropriate vein for inserting a peripheral intravenous catheter, resulting in catheter placement difficulty. Although induration affects treatment, its size, shape, or hardness remains unclear in the conventional observation method using palpation and inspection. Here, we report our observation results in using ultrasonography to assess the induration that occurred after an anticancer drug extravasation as a new assessment method.Patient concerns: A 58-year-old woman with cervical cancer who complained of pain during the administration of a nonvesicant anticancer drug via a peripheral intravenous catheter. The medical staff's examination showed a swollen site; therefore, the catheter was replaced.Diagnosis: Induration occurred on the site after an extravasation. Over 6 months later, pigmentation and induration, which can easily be confirmed through palpation, persisted.Interventions: The subcutaneous tissue in the induration site was observed using ultrasonography ( B-mode and elastography).Outcomes: The subcutaneous tissue might have degenerated the tissues surrounding the vein, making it thinner. Moreover, the hardness of the subcutaneous tissue was approximately 7 times than that of the surrounding tissues.Lessons: Induration that affects the vein form and its surrounding tissues should be prevented, and ultrasonography is an effective method to objectively observe the site where extravasation occurred.