急诊室输液患者出现药物不良反应的分析和应急护理措施讨论

Analysis of Adverse Drug Reactions of Infusion Patients in Emergency Room and Discussion on Emergency Nursing Measures

摘要: 本研究的核心目标是探讨急诊患者在接受静脉输注药物治疗过程中可能引发的副作用，并总结相应的护理干预方法。研究采用回顾性分析方法，对2012年3月至2013年12月期间因静脉给药出现不良反应的86例病例进行深入评估，旨在分析不良反应发生的潜在原因，并据此提出有效的护理对策。研究结果显示，静脉给药引发的不良反应中，药物相关反应(如毒性反应、过敏反应及消化系统反应等)占比最高，达到45.3% (39/86)。这些问题主要与静脉输注剂量过大、空腹给药、过敏反应及药物本身的副作用有关。晕针现象的发生率为24.4%，位居第二，其主要诱因包括免疫功能下降、心理压力导致的焦虑、过度疲劳、饥饿、体位不当以及环境温度过高等。此外，静脉炎的发病率为12.8%，主要与药物浓度过高、注射操作不规范及细菌感染有关，后者多因无菌操作不严格或器械污染所致。发热反应占比9.3%，主要归因于无菌操作不规范。急性肺水肿的发生率为8.2%，在7/86例患者中观察到这一现象。经对相关因素分析可知，静脉给药速度过快与剂量过大是致使药物无法有效吸收的关键因素。综上所述，在多种影响因素中，药物相关因素及护理人员操作不当对治疗效果的影响尤为显著。在急诊科进行静脉药物输注治疗时，医护人员应当严格遵循标准操作规程，并切实提高其职业责任感和工作积极性。通过采取这些措施，能够有效预防或减少不良反应的发生，进而提高静脉给药的治疗效果。

Abstract: The core goal of this study is to explore the possible side effects of emergency patients receiving intravenous infusion of drugs, and summarize the corresponding nursing intervention methods. In this study, 86 cases of adverse reactions caused by intravenous administration from March 2012 to December 2013 were deeply evaluated by retrospective analysis, aiming to analyze the potential causes of adverse reactions and put forward effective nursing countermeasures accordingly. The results showed that drug-related reactions (such as toxic reactions, allergic reactions and digestive system reactions) accounted for the highest proportion of adverse reactions caused by intravenous administration, reaching 45.3% (39/86). These problems are mainly related to excessive intravenous infusion dose, fasting administration, allergic reaction and side effects of the drug itself. The incidence of needle fainting is 24.4%, ranking second. Its main causes include decreased immune function, anxiety caused by psychological pressure, excessive fatigue, hunger, improper posture and high ambient temperature. In addition, the incidence of phlebitis is 12.8%, which is mainly related to high drug concentration, irregular injection operation and bacterial infection. The latter is mostly caused by lax aseptic operation or instrument pollution. Fever reaction accounted for 9.3%, mainly due to nonstandard aseptic operation. The incidence of acute pulmonary edema was 8.2%, which was observed in 7/86 patients. Through the analysis of related factors, it can be known that too fast intravenous administration and too large dosage are the key factors that make the drug unable to be absorbed effectively. To sum up, among many influencing factors, drug-related factors and improper operation of nursing staff have a particularly significant impact on the treatment effect. When intravenous drug infusion treatment is carried out in the emergency department, medical staff should strictly follow the standard operating procedures and effectively improve their sense of professional responsibility and work enthusiasm. By taking these measures, we can effectively prevent or reduce the occurrence of adverse reactions, and then improve the therapeutic effect of intravenous administration.