目的 分析急诊输液患者乙酰半胱氨酸不良反应的发生特点及护理对策,为临床用药安全提供参考。方法 收集南京市某三级甲等医院2019年11月—2022年8月于急诊输液室接受乙酰半胱氨酸注射液治疗且发生药物不良反应的病例26例,对其适应证、给药剂量、溶媒及溶媒量、滴注速度及药物不良反应发生时间、临床表现、严重程度、转归、对原患疾病的影响、关联性评价等进行分析。结果 所有病例均为一般不良反应,对原患疾病的影响不明显;输注乙酰半胱氨酸致发生药物不良反应平均时间为99.7 min,输注滴速为10~69滴/min;药物不良反应表现以皮肤及消化系统症状为主;不良反应关联性评价结果中,“很可能”及“肯定”占88.5%。结论 应严格按照说明书规定合理使用乙酰半胱氨酸,治疗过程中需严格控制滴速,同时重点观察患者用药前2 h的临床表现。
Objective To analyze the characteristics and nursing strategies of adverse reactions of acetylcysteine in emergency infusion patients,in order to provide reference for clinical safe medication. Methods 26 patients who had adverse drug reactions of acetylcysteine during emergency infusion were selected from November 2019 to August 2022 in a tertiary hospital in Nanjing. The analysis was performed on indication,dosages,type and amount of solvent,drip speed of acetylcysteine injection and time of adverse reactions,clinical manifestation,severity,outcome,influence on original diseases and relation evaluation. Results All of the adverse drug reactions were general adverse reactions,and had no obvious influence on their original diseases. The average time from acetylcysteine intravenous infusion to the occurrence of observed adverse drug reactions was 99.7 minutes,and drip speed ranged from 10 to 69 droplets per minute. The manifestations of adverse drug reactions were common in skin and digestive system symptoms. In relevance evaluation,“probable” and “definite” cases accounted for 88.5% of all adverse drug reactions cases. Conclusion Acetylcysteine should be strictly administrated in emergency infusion patients according to instructions. And its drip speed should be strictly controlled during the treatment. The clinical manifestation during the first 2 hours after the administration of drugs should be closely monitored.
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