도부타민 주입 화자의 정맥염 발생율과 온·냉 요법의 효과 비교 = The phlebitis rate of patients received dobutamine IV therapy and the comparison of effect between warm versus cold applications

다국어 초록 (Multilingual Abstract)

The purpose of the study is to compare the phlebitis rate between general infusate and dobutamine, determine the effect of warm versus cold applications to the sites of edema and phlebitis caused by dobutamine.
All subjects were observed during the study period from June 1st to September 15th of 1996, in the hospital at cardiology medical ward and continued to infuse general infusate and dobutamine intravenously. The sample was compared of 92 Ⅳ cases. Of the 92 cases studies, 62 cases were dobutamine and 30cases were general infusate, and among the number of 62 cases the warm aaplications were 32, the cold applications were 30. Nurses inserted the proper catheter according to the method of management when pheriperal Ⅳ catheter inserted, then described the general informtions of patients, characteristics of catheters, conditions of catheter inserted patients, the reasons of catheter removal on the Ⅳ catheter information sheet. The catheters were changed regularly when there are no symptoms of phlebitis at the site of inserted catheters, The sites of inserted catheters were observed 2 times, per every duty, The phlebitis was observed with the assessment tool about the phlebitis of Intravenous Nurses Society. When the catheters were removed because the symptoms of phlebitis at the site of inserted catheter for dobutamine Ⅳ therapy, the symptoms of phlebitis were assessed and decribed on the observation sheet of symptoms at every 9AM, After the catheters were removed, warm applications were done at A ward and cold applications were done at B ward 4 times a day for 3days, one times was 20 mins. The size of phlebitis or edema was assessed and described by measuring the width and length for 3 days. The pain and itching sense at the catheter removal site were assessed and described.
For data analysis, SPSS/PC program was utilized : t-test, chisquare test, paired t-test, percentage.
The summary of this study is as follows :
1. The comparison of the phlebitis rate between general infusate and dobutamine.
(1) There was significant difference in the phlebitis rate between general infusate(26.6%) and dobutamine(74.2%).
(2) In the phlebitis rate of general infusate, grade 2 was 3.3%, grade 3 was 3.3%. In the phlebitis rate of dobutamine, grade 2 was 12.9%, grade 3 was 4.8%.
2. The comparison of the the effect of warm verus cold applications to the site of edema and phlebitis caused by dobutamine.
(1) The width and length of phlebitis descreased significantly from the 1st to 3rd day of warm applications on the site of phlebitis.
(2) The width of phlebitis decreased on the 1st day of cold applications. But there was no significance. The width of phlebitis decreased significantly from the 2nd to 3rd day.
(3) The length of phlebitis decreased significantly from the 1st to 2nd day of cold applications on the site of phlebitis, but not decreased significantly on the 3rd day.
(4) There was no significant difference on the pain of phlebitis between the effect of warm and cold applications on the 1st day. But on the 2nd and 3rd day, the warm applications were more effective significantly than cold applications.
(5) There was no significant difference in the redness of the phlebitis between the effect of warm and cold applications at the 1st day. But the warm applications were more effective significantly than cold applications on 2nd and 3th day.
(6) There was no significant difference in the itching sense of phlebitis between the effect of warm and cold applications from the 1st and 3rd day.
According to this study, the phlebitis rate of dobutamine was higher than general infusates and the degree of phlebitis was more serious. Though the complications caused by dobutamine can not be avoided, we should observe the dobutamine infused site periodically and closely. It was difficult to make the conclusion clearly about the effects of cold applications on the decrease of diameter of phlebitis including edema, pain, and itching sense. But considering the positive effects of warm applications, active warm applications were needed on the phlebitis sites caused by dobutamine.