1%盐酸丁卡因喷剂联合中药外敷在急性皮肤 挫擦伤清创中的运用
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摘要
目的:探讨1%盐酸丁卡因喷剂联合中药外敷在急性皮肤挫擦伤患者清创术及术后换药中的运用效果。方法:将2017年2月至2018年4月在佛山市中医院急诊接受治疗的168例急性皮肤挫擦伤患者进行随机分为对照组、观察A组和观察B组,每组各56例。对照组采用常规清创术治疗,观察A组采用常规清创联合中药外敷治疗,观察B组外用1%盐酸丁卡因喷剂联合中药外敷治疗方案。比较3组患者清创术中及术后第1次换药时的视觉疼痛评分(Visual Analogue Scale,VAS),伤口感染率、伤口愈合时间及不良反应发生情况。结果:3组患者均为未发生伤口感染、伤口局部过敏及全身反应。3组患者清创术中及第1次换药时VAS评分和伤口愈合时间比较,差异均具有统计学意义(P<0.05)。进一步组间比较显示,在清创术中VAS评分,对照组与观察A组评分差异无统计学意义(P>0.05),但均显著高于观察B组(P<0.05)。第1次换药时VAS评分组间对比差异均有统计学意义(对照组>观察A组>观察B组,P<0.05)。术后伤口愈合时间比较,观察A组与观察B组差异无统计学意义(P>0.05),且均显著低于对照组(P<0.05)。结论:1%盐酸丁卡因喷剂可有效控制急性皮肤挫擦伤患者清创术中及术后换药时的疼痛感,联合中药外敷可促进伤口愈合,值得在临床进一步推广。
Objective: To investigate the effect of 1% tetracaine hydrochloride spray combined with external application of traditional Chinese medicine in patients with acute skin bruises. Methods: A total of 168 cases of acute skin bruises were randomly divided into control group, observation group A and observation group B, 56 cases in each group. The control group was treated with routine debridement. The observation group A was treated with routine debridement combined with external application of traditional Chinese medicine. The observation group B was treated with external application of 1% tetracaine hydrochloride. The Visual Analogue Scale(VAS) score, wound infection rate, wound healing time, and adverse reactions during debridement and the first dressing change were compared among the 3 groups. Results: No wound infection, local allergy and systemic reaction occurred in all the three groups. The VAS score during debridement and the first dressing change and wound healing time were significantly different among the 3 groups(P<0.05). Further comparisons between groups showed that there was no significant difference in VAS score between the control group and the observation group A(P>0.05), and both were significantly higher than the observation group B(P<0.05). There was significant difference in VAS score between groups at the first dressing change(control group > observation group A > observation group B, P<0.05). There was no significant difference in wound healing time between group A and group B(P>0.05), and both were significantly lower than the control group(P<0.05). Conclusion: 1% tetracaine hydrochloride spray can effectively control the pain of acute skin contusion patients during debridement and dressing change after operation. Combination of external application of traditional Chinese medicine can promote wound healing and is worthy of further promotion in clinical practice.
Objective: To investigate the effect of 1% tetracaine hydrochloride spray combined with external application of traditional Chinese medicine in patients with acute skin bruises. Methods: A total of 168 cases of acute skin bruises were randomly divided into control group, observation group A and observation group B, 56 cases in each group. The control group was treated with routine debridement. The observation group A was treated with routine debridement combined with external application of traditional Chinese medicine. The observation group B was treated with external application of 1% tetracaine hydrochloride. The Visual Analogue Scale(VAS) score, wound infection rate, wound healing time, and adverse reactions during debridement and the first dressing change were compared among the 3 groups. Results: No wound infection, local allergy and systemic reaction occurred in all the three groups. The VAS score during debridement and the first dressing change and wound healing time were significantly different among the 3 groups(P<0.05). Further comparisons between groups showed that there was no significant difference in VAS score between the control group and the observation group A(P>0.05), and both were significantly higher than the observation group B(P<0.05). There was significant difference in VAS score between groups at the first dressing change(control group > observation group A > observation group B, P<0.05). There was no significant difference in wound healing time between group A and group B(P>0.05), and both were significantly lower than the control group(P<0.05). Conclusion: 1% tetracaine hydrochloride spray can effectively control the pain of acute skin contusion patients during debridement and dressing change after operation. Combination of external application of traditional Chinese medicine can promote wound healing and is worthy of further promotion in clinical practice.
引文
1.黄国梅,刘丽瑜,胡德泉.黄油纱配合黄水纱外敷护理皮肤软组织挫擦伤的效果[J].实用临床医学,2016,17(12):76-77.HUANG Guomei,LIU Liyu,HU Dequan.Effect of butter gauze combined with yellow water gauze on skin and soft tissue contusion and abrasion[J].Practical Clinical Medicine,2016,17(12):76-77.
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7.陈静,宋海涛.盐酸达克罗宁胶浆复合丁卡因表面麻醉在电子喉镜下急诊咽喉部异物取出术中的效果观察[J].河南外科学杂志,2018,24(5):75-76.CHEN Jing,SONG Haitao.Observation on the effect of topical anesthesia with dacronin hydrochloride and tetracaine in emergency phar y nx and lar y nx foreign body removal under electronic laryngoscope[J].Henan Journal of Surgery,2018,24(5):75-76.
8.郝延红,席俊峰,李婉宁.胸腔镜两孔法术式对肺大疱切除的疗效及VAS评分的影响[J].河北医学,2018,24(1):65-69.HAO Yanhong,XI Junfeng,LI Wanning.Effect of thoracoscopic twohole method on pulmonary bulla resection and the effect of VASscore[J].Hebei Medicine,2018,24(1):65-69.
9.蒋琪霞,李晓华,周昕,等.红光和红外线辅助治疗创伤性伤口减痛促愈效果观察[J].护理学杂志,2012,27(22):19-22.JIANG Qixia,LI Xiaohua,ZHOU Xin,et al.Effects of red light and far infrared ray(FIR)irradiation on pain relief and healing of traumatic wounds[J].Journal of Nursing Science,2012,27(22):19-22.
10.覃丽.创建“骨科无痛病房”的实践与探讨[J].吉林医学,2012,33(2):329.QIN Li.Practice and discussion on establishing“orthopaedic painless ward”[J].Jilin Medical Journal,2012,33(2):329.
11.韩凤莲.骨科患者术后疼痛的影响因素与护理进展[J].护理实践与研究,2011,8(23):113-114.HAN Fenglian.Inf luencing factors and nursing progress of postoperative pain in orthopaedic patients[J].Nursing Practice and Research,2011,8(23):113-114.
12.王汉兵.200例患者心血管术后疼痛的流行病学调查冠脉搭桥术后病人自控镇育的临床研究[D].武汉:武汉大学,1999.WANG Hanbing.Epidemiological investigation of postoperative pain in 200 patients:a clinical study of patient-controlled analgesia after coronary artery bypass grafting[D].Wuhan:Wuhan University,1999.
13.杨敏敏,谢江凌,龚正菊.盐酸丁卡因胶浆在前列腺增生病人导尿中的应用[J].护理实践与研究,2013,10(12):105-106.YANG Minmin,XIE Jiangling,GONG Zhengju.Application of tetracaine hydrochloride gel in catheterization of patients with benign prostatic hyperplasia[J].Nursing Practice and Research,2013,10(12):105-106.
14.全海舟,李利群.盐酸丁卡因胶浆缓解肌内注射患者疼痛的效果观察[J].护理学报,2015,22(5):61-62.QUAN Haizhou,LI Liqun.Observation on the effect of tetracaine hydrochloride mucilage on pain relief in patients undergoing intramuscular injection[J].Journal of Nursing,2015,22(5):61-62.
15.贾茹,鲁红梅,王莉,等.盐酸丁卡因胶浆在人工流产术中的应用[J].中国药业,2011,20(13):58.JIA Ru,LU Hongmei,WANG Li,et al.Application of tetracaine hydrochloride gel in induced abortion[J].China Pharmaceuticals,2011,20(13):58.
16.鞠盈洁.1例盐酸丁卡因表面麻醉致心跳骤停患者的护理[J].中国实用护理杂志,2008,24(33):45.JU Yingjie.Nursing care of a patient with cardiac arrest caused by topical anesthesia with tetracaine hydrochloride[J].Chinese Journal of Practical Nursing,2008,24(33):45.
17.童文婷,劳海燕,张辉,等.盐酸丁卡因胶浆行尿道黏膜麻醉致速发型过敏反应1例报告[J].现代泌尿外科杂志,2018,23(7):560.TONG Wenting,L AO Haiyan,ZHANG Hui,et al.One case of anaphylax is induced by tetracaine hydrochloride mucosal anaesthesia[J].Journal of Modern Urology,2018,23(7):560.
2.李小红,颜娟.美宝创疡贴治疗骨折患者皮肤软组织挫擦伤[J].中国烧伤创疡杂志,2011,23(3):234-235.LI Xiaohong,YAN Juan.MEBO wound and ulcer dressing in the treatment of skin soft tissue contusion in fracture patients[J].The Chinese Journal of Burns Wounds and Surface Ulcers,2011,23(3):234-235.
3.赵志蓉,刘月丽,吕传柱,等.双氯芬酸钠盐酸利多卡因注射液治疗四肢急性创伤性骨折及软组织损伤的镇痛疗效和安全性评价[J].中华灾害救援医学,2015,3(3):140-143.ZHAO Zhirong,LIU Yueli,LüChuanzhu,et al.Analgesic efficacy and safety evaluation on diclofenac sodium and lidocaine hydrochloride injection in the treatment of acute traumatic limbs fracture and soft tissue injury[J].Chinese Journal of Disaster Medicine,2015,3(3):140-143.
4.刘爽.心理护理和舒适护理对创伤骨科急诊患者的影响分析[J].中国医药指南,2016,14(14):242.LIU Shuang.The impact of psychological nursing and comfort nursing on emergency patients in orthopaedic trauma department[J].Guide of China Medicine,2016,14(14):242.
5.杨燕,杜娴,陶晓红,等.盐酸丁卡因在留置胃管中的应用[J].国际护理学杂志,2014,33(1):238-239.YANG Yan,DU Xian,TAO Xiaohong,et al.Application of tetracaine hydrochloride in indwelling gastric tube[J].International Journal of Nursing,2014,33(1):238-239.
6.安小芳,李小颖,王学良,等.1%盐酸丁卡因凝胶在男性患者留置导尿术中的应用效果分析[J].安徽医药,2017,21(9):1666-1668.AN Xiaofang,LI Xiaoying,WANG Xueliang,et al.Application effect of 1%tetracaine hydrochloride gel in male patients with indwelling catheterization[J].Anhui Medical and Pharmaceutical Journal,2017,21(9):1666-1668.
7.陈静,宋海涛.盐酸达克罗宁胶浆复合丁卡因表面麻醉在电子喉镜下急诊咽喉部异物取出术中的效果观察[J].河南外科学杂志,2018,24(5):75-76.CHEN Jing,SONG Haitao.Observation on the effect of topical anesthesia with dacronin hydrochloride and tetracaine in emergency phar y nx and lar y nx foreign body removal under electronic laryngoscope[J].Henan Journal of Surgery,2018,24(5):75-76.
8.郝延红,席俊峰,李婉宁.胸腔镜两孔法术式对肺大疱切除的疗效及VAS评分的影响[J].河北医学,2018,24(1):65-69.HAO Yanhong,XI Junfeng,LI Wanning.Effect of thoracoscopic twohole method on pulmonary bulla resection and the effect of VASscore[J].Hebei Medicine,2018,24(1):65-69.
9.蒋琪霞,李晓华,周昕,等.红光和红外线辅助治疗创伤性伤口减痛促愈效果观察[J].护理学杂志,2012,27(22):19-22.JIANG Qixia,LI Xiaohua,ZHOU Xin,et al.Effects of red light and far infrared ray(FIR)irradiation on pain relief and healing of traumatic wounds[J].Journal of Nursing Science,2012,27(22):19-22.
10.覃丽.创建“骨科无痛病房”的实践与探讨[J].吉林医学,2012,33(2):329.QIN Li.Practice and discussion on establishing“orthopaedic painless ward”[J].Jilin Medical Journal,2012,33(2):329.
11.韩凤莲.骨科患者术后疼痛的影响因素与护理进展[J].护理实践与研究,2011,8(23):113-114.HAN Fenglian.Inf luencing factors and nursing progress of postoperative pain in orthopaedic patients[J].Nursing Practice and Research,2011,8(23):113-114.
12.王汉兵.200例患者心血管术后疼痛的流行病学调查冠脉搭桥术后病人自控镇育的临床研究[D].武汉:武汉大学,1999.WANG Hanbing.Epidemiological investigation of postoperative pain in 200 patients:a clinical study of patient-controlled analgesia after coronary artery bypass grafting[D].Wuhan:Wuhan University,1999.
13.杨敏敏,谢江凌,龚正菊.盐酸丁卡因胶浆在前列腺增生病人导尿中的应用[J].护理实践与研究,2013,10(12):105-106.YANG Minmin,XIE Jiangling,GONG Zhengju.Application of tetracaine hydrochloride gel in catheterization of patients with benign prostatic hyperplasia[J].Nursing Practice and Research,2013,10(12):105-106.
14.全海舟,李利群.盐酸丁卡因胶浆缓解肌内注射患者疼痛的效果观察[J].护理学报,2015,22(5):61-62.QUAN Haizhou,LI Liqun.Observation on the effect of tetracaine hydrochloride mucilage on pain relief in patients undergoing intramuscular injection[J].Journal of Nursing,2015,22(5):61-62.
15.贾茹,鲁红梅,王莉,等.盐酸丁卡因胶浆在人工流产术中的应用[J].中国药业,2011,20(13):58.JIA Ru,LU Hongmei,WANG Li,et al.Application of tetracaine hydrochloride gel in induced abortion[J].China Pharmaceuticals,2011,20(13):58.
16.鞠盈洁.1例盐酸丁卡因表面麻醉致心跳骤停患者的护理[J].中国实用护理杂志,2008,24(33):45.JU Yingjie.Nursing care of a patient with cardiac arrest caused by topical anesthesia with tetracaine hydrochloride[J].Chinese Journal of Practical Nursing,2008,24(33):45.
17.童文婷,劳海燕,张辉,等.盐酸丁卡因胶浆行尿道黏膜麻醉致速发型过敏反应1例报告[J].现代泌尿外科杂志,2018,23(7):560.TONG Wenting,L AO Haiyan,ZHANG Hui,et al.One case of anaphylax is induced by tetracaine hydrochloride mucosal anaesthesia[J].Journal of Modern Urology,2018,23(7):560.
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