2%利多卡因局部麻醉皮肤擦伤伤口对减轻清创时疼痛的效果观察

Effect of externally applied 2% lidocaine on abrasion wound on relieving of pains during debridement

目的观察2%利多卡因局部麻醉皮肤擦伤伤口对减轻清创时疼痛程度的效果。方法选择2011年1～9月本院急诊科109例急性皮肤擦伤患者,按入院的单双号分为实验组54例和对照组55例。对照组给予无菌生理盐水外涂擦伤伤口,5min后开始常规伤口清创术;实验组给予2%利多卡因局部麻醉擦伤伤口,5min后开始伤口清创术,比较两组患者在清创过程中疼痛程度的差异。结果两组患者清创过程疼痛评分高于清创前(均P<0.05);实验组清创过程疼痛评分低于对照组,伤口愈合时间短于对照组,对清创疼痛程度的接受率高于对照组(均P<0.05);两组患者感染发生率比较,P>0.05,差异无统计学意义。结论皮肤擦伤伤口在清创过程中可引起患者明显的疼痛感,用2%利多卡因局部麻醉伤口后再行清创,可明显降低清创过程的疼痛感,使疼痛强度控制在患者可接受的范围之内,从而使伤口得到彻底的清洗,促进了伤口愈合。

Objective To investigate the effect of externally-applied 2% lidoeaine on skin abrasion wound on relieving pains during debridement. Methods 109 patients with acute abrasion wounds in emergency department of our hospital between January and September, 2011 were divided according to the odd or even registration number into experiment group （n = 54） and control group （n = 55 ）. In the control group, normal saline was administered on wound surfaces and routine debridement was performed 5 minutes later. In the experiment group, 2% lidocaine was used on wound surface, followed by debridement 5 minutes later. The pain intensity during debridement was compared between the two groups. Result In both groups, the pain scores during debridement were higher than those before debridement. The pain scores during debridement in the experiment group were higher than that to the control group. The average healing time of the experiment group was shorter than that of the control group and the degree for standing the debridement-induced pains in the experiment group was higher than that in the control group （all P 〈 0.05）. There was no significant difference in wound infection rate between the two groups （P 〉 0.05）. Conclusion The abrasion wound may lead to a sharp feeling of pains during the process debridement. 0.2% lidocaine administered on the surface of abrasion wound before debridement can notably decrease the pain intensity during debridement and make the pain bearable so that the wounds may be thoroughly cleaned and ultimately the wound healing can be accelerated.