Incidence, risk factors and treatment outcomes of extravasation of cytotoxic agents in an outpatient chemotherapy clinic
Incidence, risk factors and treatment outcomes of extravasation of cytotoxic agents in an outpatient chemotherapy clinic
复制标题
门诊化疗诊所细胞毒药物外渗的发生率、危险因素及治疗结果
作者：
Sakaida;E. Sekine;I. Iwasawa;S. Kurimoto;R. Uehara;T. Ooka;Y. Akanuma;N. Tada;Y. Imai;C. Oku;T. Takiguchi;Y.
外渗是指抗癌药物意外地从血管渗漏到周围组织，可导致局部不可逆转的损伤和严重残疾。尽管它具有相当大的临床重要性，但缺乏关于化疗中外渗的循证信息。本研究通过对2007年4月至2012年8月在我科门诊接受化疗并持续渗出的患者的病历资料进行回顾，分析了目前在门诊进行的癌症化疗中存在的渗漏的临床特征。结果43 557例接受化疗的患者中，35例(0.08%)发生外渗。28例(80.0%)患者从开始输液到外渗的时间为2小时。渗出严重程度分别为1级、2级和3级的患者分别为28例、2例和5例，其中3例与端口故障有关。11例(31.4%)患者的渗漏因素是步行。根据我们的指导方针，所有的渗漏均在没有手术干预的情况下治愈。结论根据我们的内部化疗指南，渗漏的发生率低至0.08%。从植入的端口渗出往往是严重的。
ObjectiveExtravasation, the accidental leakage of an anticancer agent from a vessel into the surrounding tissues, can lead to irreversible local injuries and severe disability. Despite its considerable clinical importance, evidence-based information on extravasation in chemotherapy is lacking. This study characterized the clinical features of extravasation and identified issues to be resolved in current cancer chemotherapy performed in outpatient settings.MethodsWe retrospectively reviewed the medical charts of patients who received chemotherapy and sustained extravasation in our Outpatient Chemotherapy Clinic from April 2007 to August 2012. Chemotherapy administration and extravasation management procedures were standardized using the in-house chemotherapy guideline.ResultsAmong 43 557 patients who received chemotherapy, 35 (0.08%) experienced extravasation. The duration between the start of infusion and extravasation was >2 h in 28 (80.0%) patients. The severity of extravasation was Grades 1, 2 and 3 in 28, 2 and 5 patients, respectively—three of whom were associated with port trouble. The contributing factor for extravasation was walking in 11 (31.4%) patients. All extravasations were cured without surgical intervention by management according to our guidelines.ConclusionsThe incidence of extravasation is as low as 0.08%, using our in-house chemotherapy guideline. Extravasation from implanted ports tends to be severe.