内容紹介
Risk Factors for Oxaliplatin-Induced Phlebitis and Venous Pain, and Evaluation of the Preventive Effect of Preheating with a Hot Compress for Administration of Oxaliplatin
Summary
Venous pain induced by oxaliplatin(L-OHP)is a clinical issue related to adherence to the CapeOX regimen. To prevent L-OHP-induced venous pain, we provided nursing care to outpatients who were administered a preheated L-OHP diluted solution using a hot compress. We retrospectively evaluated the risk factors for colorectal cancer patients who had L-OHP-induced phlebitis and venous pain. Furthermore, the preventive effect of nursing care was compared between inpatients and outpatients from January 2010 to March 2012. At the L-OHP administration site, any symptoms were defined as phlebitis, whereas pain was defined as venous pain. A total of 132 treatment courses among 31 patients were evaluated. Multivariate logistic regression analysis revealed that both phlebitis and venous pain were significantly more common in female patients(adjusted odds ratio, 2.357; 95%CI: 1.053-5.418; and adjusted odds ratio, 5.754; 95%CI: 2.119-18.567, respectively). The prevalence of phlebitis and venous pain did not differ between inpatients and outpatients(phlebitis, 61.3% vs 67.7%; venous pain, 29.0% vs 19.4%). These results suggest that administration of L-OHP via a central venous route should be considered in female patients.
要旨
実地臨床では,CapeOXレジメンにおけるオキサリプラチン(L-OHP)の血管痛は治療アドヒアランスの障害となる。われわれは,L-OHPの血管痛を予防するため外来化学療法患者を対象に,L-OHP希釈液の加温投与ならびに温罨法による看護ケアを行っている。また,L-OHP誘発静脈炎と血管痛を発現した大腸がん患者の危険因子を後方視的に評価した。さらに,看護ケアの予防効果は2010年1月～2012年3月の期間で入院患者と外来患者で比較した。L-OHP投与部位にいずれかの症状がある場合を静脈炎と定義し,一方で痛みを有する場合を血管痛と定義した。患者31名,総投与132コースを評価対象とした。多変量解析の結果,静脈炎および血管痛の有意な要因として女性患者が抽出された(調整オッズ比: 2.357,95%信頼区間: 1.053-5.418と調整オッズ比: 5.754,95%信頼区間: 2.119-18.567)。静脈炎と血管痛の発現率は入院患者と外来患者で変わらなかった(静脈炎61.3% vs 67.7%,血管痛は29.0% vs 19.4%)。以上より,女性患者においてL-OHPは中心静脈からの投与を検討すべきである。
目次
Summary
Venous pain induced by oxaliplatin(L-OHP)is a clinical issue related to adherence to the CapeOX regimen. To prevent L-OHP-induced venous pain, we provided nursing care to outpatients who were administered a preheated L-OHP diluted solution using a hot compress. We retrospectively evaluated the risk factors for colorectal cancer patients who had L-OHP-induced phlebitis and venous pain. Furthermore, the preventive effect of nursing care was compared between inpatients and outpatients from January 2010 to March 2012. At the L-OHP administration site, any symptoms were defined as phlebitis, whereas pain was defined as venous pain. A total of 132 treatment courses among 31 patients were evaluated. Multivariate logistic regression analysis revealed that both phlebitis and venous pain were significantly more common in female patients(adjusted odds ratio, 2.357; 95%CI: 1.053-5.418; and adjusted odds ratio, 5.754; 95%CI: 2.119-18.567, respectively). The prevalence of phlebitis and venous pain did not differ between inpatients and outpatients(phlebitis, 61.3% vs 67.7%; venous pain, 29.0% vs 19.4%). These results suggest that administration of L-OHP via a central venous route should be considered in female patients.
要旨
実地臨床では,CapeOXレジメンにおけるオキサリプラチン(L-OHP)の血管痛は治療アドヒアランスの障害となる。われわれは,L-OHPの血管痛を予防するため外来化学療法患者を対象に,L-OHP希釈液の加温投与ならびに温罨法による看護ケアを行っている。また,L-OHP誘発静脈炎と血管痛を発現した大腸がん患者の危険因子を後方視的に評価した。さらに,看護ケアの予防効果は2010年1月～2012年3月の期間で入院患者と外来患者で比較した。L-OHP投与部位にいずれかの症状がある場合を静脈炎と定義し,一方で痛みを有する場合を血管痛と定義した。患者31名,総投与132コースを評価対象とした。多変量解析の結果,静脈炎および血管痛の有意な要因として女性患者が抽出された(調整オッズ比: 2.357,95%信頼区間: 1.053-5.418と調整オッズ比: 5.754,95%信頼区間: 2.119-18.567)。静脈炎と血管痛の発現率は入院患者と外来患者で変わらなかった(静脈炎61.3% vs 67.7%,血管痛は29.0% vs 19.4%)。以上より,女性患者においてL-OHPは中心静脈からの投与を検討すべきである。