健康成人を対象にした点滴静脈内注射の血管外漏出モデルにおけるサーモグラフィー画像の分析  [in Japanese] Analysis of thermographic images in an extravasation model of intravenous infusion in healthy adults  [in Japanese]

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Author(s)

    • 須釜 淳子 Sugama Junko
    • 金沢大学医薬保健研究域附属健康増進科学センター Wellness Promotion Science Center, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
    • 真田 弘美 Sanada Hiromi
    • 東京大学大学院医学系研究科健康科学・看護学専攻老年看護学/創傷看護学分野 Department of Gerontological Nursing/Wound Care Management, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo
    • 村山 陵子 Murayama Ryouko
    • 東京大学大学院医学系研究科社会連携講座アドバンストナーシングテクノロジー Deparment of Advanced Nursing Technology, Gtaduate School of Medicine, The University of Tokyo
    • 田邊 秀憲 Tanabe Hidenori
    • 東京大学大学院医学系研究科社会連携講座アドバンストナーシングテクノロジー|テルモ株式会社 Deparment of Advanced Nursing Technology, Gtaduate School of Medicine, The University of Tokyo|Terumo Corpporation
    • 大江 真琴 Oe Makoto
    • 東京大学大学院医学系研究科社会連携講座アドバンストナーシングテクノロジー Deparment of Advanced Nursing Technology, Gtaduate School of Medicine, The University of Tokyo

Abstract

  点滴静脈内注射の血管外漏出は皮膚に炎症や潰瘍を引き起こすことがあるため,早期発見が重要である.しかし,臨床の看護師による血管外漏出の鑑別方法は客観性に乏しい.本研究は,血管外漏出の有無の客観的評価指標の開発を目的に,健常者6名を対象にサーモグラフィーを用いて血管外漏出を鑑別できることを検証した.漏出モデルとして,前腕の皮下組織に留置針を刺入し生理食塩水を1.7ml/分で滴下した.対照群として,反対側の前腕の静脈内に留置針を刺入し,同様に滴下した.漏出の確認として,超音波診断装置を用いて留置針先端の位置と,滴下前後の皮下組織の厚さを観察した.滴下後10秒ごとにサーモグラフィーで針先周囲を撮影したところ,漏出モデルでは6名全員に滴下開始2分以内に針先を中心に広がる円形の低温域が出現した.サーモグラフィーにより,非接触的かつ迅速に点滴静脈内注射の血管外漏出が鑑別できる可能性が示唆された.

  Early detection of extravasation in intravenous drip infusions is important because it causes inflammation and ulcers on the skin. However, in clinical situations, nurses determine extravasation using low-objectivity methods. The purpose of this study was thus to develop objective indicators for identifying extravasation. Subjects comprised six healthy men and women who underwent observation for extravasation using thermography. As a model of extravasation, saline was drip-infused at 1.7 ml/min through a catheter inserted into the subcutaneous tissue of the forearm. As a control group, saline was drip-infused through a catheter placed in a vein in the contralateral forearm at the same rate. To confirm that saline was leaking into the subcutaneous tissue, we observed the position of the catheter and the thickness of the subcutaneous tissue both before and after infusion using ultrasonography. Thermographic imaging around the tip of the catheter was performed every 10s from the start of infusion. In all subjects, thermography showed a low-temperature region appearing at the catheter tip within 2 min of starting infusion. These results suggest that thermography can be used to identify extravasation in a fast and non-invasive manner.

Journal

  • Journal of Nursing Science and Engineering

    Journal of Nursing Science and Engineering 1(1), 4-11, 2014

    The Society for Nursing Science and Engineering

Codes

  • NII Article ID (NAID)
    130006406469
  • Text Lang
    JPN
  • ISSN
    2188-4323
  • Data Source
    J-STAGE 
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