摘要
目的探讨中药如意金黄散早期湿敷在药物外渗性皮肤损伤中的效果。方法采用便利抽样法,选择2017年1月—2019年12月东部战区总医院和连云港市第一人民医院2所医院不同药物外渗引起皮肤损伤的21例患者为研究对象,根据红肿面积调制如意金黄散局部湿敷,每日更换1次,直至疼痛、红肿缓解,损伤愈合。出现不可逆组织坏死者按照伤口护理原则给予清创、抗感染、负压治疗或湿性疗法至伤口愈合。分别比较湿敷前后、上下肢、24 h内湿敷和24 h后湿敷以及不同药物外渗的患者的疼痛计分、红肿面积及愈合时间、愈合效果。结果经过调制如意金黄散湿敷2~13 d后,18例外渗后2~24 h接受湿敷者皮肤损伤全部愈合,愈合时间为(6.44±2.99)d;3例形成伤口,经过局部清创、抗感染、湿性疗法和负压治疗等全部愈合,愈合时间为67(28,154)d。湿敷前分别与湿敷后第1~7天的疼痛计分比较,差异均有统计学意义(P<0.05);湿敷前分别与湿敷后第1~5天的红肿面积比较,差异均有统计学意义(P<0.05),第6天与第7天的红肿面积比较,差异无统计学意义(P>0.05)。湿敷前上下肢外渗后的疼痛计分和红肿面积比较,差异无统计学意义(P>0.05)。湿敷后3 d,上肢疼痛计分小于下肢,上下肢疼痛计分比较差异有统计学意义(P<0.05),但下肢和上肢红肿面积比较差异无统计学意义(P>0.05)。不同湿敷时间组湿敷前的疼痛计分和红肿面积比较,差异无统计学意义(P>0.05)。湿敷后3 d,24 h内湿敷患者疼痛计分低于24 h后湿敷患者,两组患者红肿面积比较差异无统计学意义(P>0.05)。24 h内湿敷患者的愈合时间短于24 h后湿敷患者,两组愈合时间比较差异有统计学意义(P<0.05)。不同药物外渗患者湿敷前的疼痛计分和红肿面积比较,差异无统计学意义(P>0.05)。湿敷后3 d,抗生素外渗组疼痛计分和红肿面积比较,差异无统计学意义(P>0.05)。结论调制如意金黄散早期湿敷药物外渗性皮肤损伤安全、有效,药物外渗后越早湿敷效果越好。
Objective To explore the effects of early wet compress with traditional Chinese medicine Ru-Yi-Jin-Huang-San on drug extravasation skin injury.Methods Totally 21 patients with skin injuries caused by extravasation of different drugs from the First People's Hospital of Lianyungang and General Hospital of Eastern Theater Command between January 2017 and December 2019 were selected by convenient sampling.They received local wet compress with Ru-Yi-Jin-Huang-San according to the redness and swelling area,which was replaced once a day until the pain and swelling were ameliorated and the wound healed.Patients with irreversible tissue necrosis underwent debridement,anti-infection,negative pressure wound treatment or wet therapy according to the principles of wound care until the wound healed.The pain score,redness area,healing time and healing outcome were compared before and after wet compress,between upper and lower limbs,between wet compress within 24 hours and wet compress after 24 hours,and between patients with and without drug extravasation.Results After wet compress with Ru-Yi-Jin-Huang-San for 2-13 days,the skin injury of 18 patients who received wet compress within 2-24 hours after extravasation healed completely,and the healing time was(6.44±2.99)d;3 cases formed wounds,which healed after local debridement,anti-infection,wet therapy and negative pressure therapy,with a healing time of 67(28,154)d.There were statistically significant difference between the pain score before wet compress and those from day 1 to day 7 after wet compress(P<0.05);there were statistically significant differences between the redness and swelling area before wet compress and those from day 1 to day 5 after wet compress(P<0.05);there was no statistically significant difference in the redness and swelling area between day 6 and day 7(P>0.05).There were no statistically significant differences in the pain score and the redness and swelling area between the upper and lower extremities before wet compress(P>0.05).3 days after wet compress,the pain score of the upper extremities was lower than that of the lower extremities,and the difference was statistically significant(P<0.05),but there was no statistically significant difference in the redness and swelling area between the lower extremities and the upper extremities(P>0.05).Before wet compress,there was no statistically significant difference in the pain score and the redness and swelling area between the groups with different time of wet compress(P>0.05).3 days after wet compress,the pain score of patients who received wet compress within 24 hours was lower than that of patients who received wet compress after 24 hours(P>0.05).The healing time of patients who received wet compress within 24 hours was shorter than that of patients who received wet compress after 24 hours,and the difference between the two groups was statistically significant(P<0.05).Before wet compress,there were no significant differences in pain score and the redness and swelling area between the groups with extravasation of different drugs(P>0.05).3 days after wet compress,there were no statistically significant differences in the pain score and the redness and swelling area within the antibiotic extravasation group(P>0.05).Conclusions Early wet compress with Ru-Yi-Jin-Huang-San is safe and effective for drug extravasation skin injury.The sooner the wet compress,the better the effect is.
作者
李来娟
蒋琪霞
谷宇
彭青
黄秀玲
薛嘉宇
Li Laijuan;Jiang Qixia;Gu Yu;Peng Qing;Huang Xiuling;Xue Jiayu(Wound Stomatology Clinics,the First People's Hospital of Lianyungang,Lianyungang 222002,China;Wound Care Center,Outpatient Services,General Hospital of Eastern Theater Command,Nanjing 210002,China)
出处
《中华现代护理杂志》
2020年第13期1783-1788,共6页
Chinese Journal of Modern Nursing
基金
上海王正国创伤医学发展基金会课题(WZGF20200101)。
关键词
药物外渗
皮肤损伤
中医中药
湿性疗法
愈合
Drug extravasation
Skin injury
Traditional Chinese medicine
Wet therapy
Healing
作者简介
通信作者:蒋琪霞,Email:jiangqixia1963@163.com。
