一例促皮质素静脉外渗至局部皮肤坏死的案例解析与改进  

Analysis and Improvement of One Case of Venous Extravasation of Adrenocorticotropic Hormone to Local Skin Necrosis

作　　者：卜丽君 陈丽[1] 周昀箐 王翠锦 王英燕 韩凤 王纪文[2] 李浩[3] BU Lijun;CHEN Li;ZHOU Yunqing(Shanghai Childrens Medical Center,School of Medicine,Shanghai Jiao Tong University,Shanghai,200127,China;不详)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心,上海200127 [2]上海交通大学医学院附属上海儿童医学中心神经内科,上海200127 [3]上海交通大学医学院附属上海儿童医学中心临床研究管理中心,上海200127

出　　处：《中国卫生质量管理》2022年第9期49-51,80,共4页Chinese Health Quality Management

基　　金：2019年上海市“医苑新星”青年医学人才培养资助计划——临床药师项目(沪卫人事[2020]87号);上海市卫生健康委员会卫生行业临床研究专项——青年项目(编号:20204Y0339)。

摘　　要：对1例癫痫性痉挛患儿采用促皮质素静脉给药时发生静脉外渗至局部皮肤坏死的案例进行解析。针对事件发生原因,制定并采取措施:静脉穿刺难度事前评估,优化临床监护,加强相关知识培训,以肌肉注射代替静脉滴注等,避免了此类事件的再次发生,提升了临床合理用药水平,确保了患者安全。A case of local skin necrosis caused by venous extravasation during intravenous administration of adreno corticotropic hormone in a child with epileptic spasm was analyzed.In view of the causes of the incident,measures were formulated and implemented,including pre-assessment of the difficulty of venipuncture,optimization of clinical monitoring,strengthening relevant knowledge training,and replacing intravenous infusion with intramural injection,so as to avoid the recurrence of such incidents and improve the level of rational drug use in clinical practice and ensure patient safety.

关 键 词：癫痫性痉挛 促皮质素 静脉给药 护理质量 患者安全 

分 类 号：R97.323[医药卫生—药品] R95[医药卫生—药学]