一例多西环素相关性儿童贵要静脉血栓的 “防–治–康”阶梯式护理实践

A Stepwise “Prevention-Treatment-Rehabilitation” Nursing Practice for a Child with Doxycycline-Associated Basilic Vein Thrombosis

摘要: 目的：总结1例多西环素静脉输注致贵要静脉血栓患儿的护理经验，探讨儿科高刺激性药物静脉治疗并发症的系统化管理策略。方法：回顾性分析1例10岁肺炎患儿的临床资料，其在输注多西环素后发生药物相关性静脉血栓。护理团队实施基于“预防–治疗–康复”理念的阶梯式护理实践：在预防阶段，强化对高刺激性药物输注风险的识别，实施动态、前瞻性血管评估；在治疗阶段，协同医生精准执行低分子肝素钙抗凝治疗，严密监测出血风险，并采用多磺酸粘多糖乳膏外敷、患肢抬高、疼痛管理等综合干预措施；在康复阶段，针对患儿及家属实施以家庭为中心的心理支持与健康指导。结果：经过4天的系统化护理，患儿手臂肿胀完全消退，复查彩色多普勒超声显示血栓溶解，血流信号恢复，康复出院。结论：本案例所应用的“防–治–康”阶梯式护理模式，为儿科高刺激性药物所致静脉血栓的系统化管理提供了一个有益的实践参考。其强调主动预防、精准治疗与全程康复的整合，可能有助于改善患者预后。然而，其有效性仍需在更大规模的研究中得到验证。

Abstract: Objective: To summarize the nursing experience of a pediatric patient with basilic vein thrombosis caused by intravenous doxycycline infusion, and to explore a systematic management strategy for complications associated with highly irritating intravenous medications in children. Methods: Clinical data of a 10-year-old child with pneumonia who developed drug-related venous thrombosis after doxycycline infusion were retrospectively analyzed. A “Prevention-Treatment-Rehabilitation” stepwise nursing model was implemented. In the prevention phase, nursing interventions focused on risk identification of highly irritating drugs and dynamic, prospective vascular assessments. In the treatment phase, precise administration of anticoagulation therapy (subcutaneous low molecular weight heparin calcium) was performed with close bleeding risk monitoring, alongside comprehensive local symptom management including topical application of mucopolysaccharide polysulfate cream, limb elevation, and pain control. In the rehabilitation phase, family-centered psychological support and health education were provided. Results: After four days of systematic nursing care, the child’s arm swelling completely resolved. Follow-up color Doppler ultrasound confirmed thrombus dissolution and restored blood flow, leading to successful discharge. Conclusion: The “prevention-treatment-rehabilitation” stepped nursing model applied in this case offers a useful practical reference for the systematic management of venous thrombosis induced by highly irritating drugs in pediatrics. Its emphasis on integrating active prevention, precise treatment, and comprehensive rehabilitation may help improve patient outcomes. However, its effectiveness still needs to be validated in larger-scale studies.