职业性手臂振动病50例临床分析与综合护理干预

Clinical analysis and comprehensive nursing intervention on 50 cases of occupational hand-arm vibration disease

目的探讨职业性手臂振动病(HAVD)临床特点和综合护理干预措施。方法回顾性分析2010年4月—2011年8月广东省职业病防治院50例HAVD的临床资料及护理措施。结果 50例患者治疗前,手麻、手痛、双手痛觉、振动觉减弱、异常神经-肌电图(ENMG)以及异常冷水复温试验(CWLT)例数分别为50,38,49,30,50和47例。予中西医结合治疗后,上述指标消失或好转例数分别为48,36,34,17,48和40例,总体治疗有效率达96.0%。与治疗前比较,差异有统计学意义(P<0.05)。在住院过程中经加强中药熏洗的安全护理、穴位注射治疗观察和护理、心理护理等综合护理干预措施,仅5例出现穴位注射疼痛,高压氧治疗时有1例耳痛和1例耳鸣,经对症处理症状消失。结论中西医结合治疗HAVD有一定疗效,做好心理护理可提高患者治疗的依从性,实施综合护理措施能促进患者康复,提高其生活质量。

[ Objective] To explore the clinical characteristics and comprehensive nursing intervention measures of occupational hand-arm vibration disease （HAVD）. [ Methods ] The clinical data and nursing measures of 50 HAVD cases in Guangdong Preven- tion and Treatment Center for Occupational Disease from April 2010 to August 2011 were analyzed retrospectively. [ Results ] Before the therapy, the number of patients had the finger numbness, tingling, cheiralgia, hypoalgesia of hands, pallhypesthesia, abnormal result of electroneuromyography （ ENMG ） and abnormal result of cold water loading test （ CWLT ） was 50, 38, 49, 30, 50 and 47, respectively. After the therapy of integrated traditional Chinese and Western Medicine, the number of patients were cured or im- proved in these indexes was respectively 48, 36, 34, 17, 48 and 40, with the total effective rate of 96.0%, and there was signifi- cant difference between before and after therapy （ P 〈 0.05 }. With the comprehensive nursing intervention measures, such as safe nursing on fumigation of Chinese medicine, observation and nursing on acupoint injection and mental nursing, only 5 patients felt pain of acupoint injection, while 1 otalgia case and 1 tinnitus case were found in hyperbaric oxygen therapy, and those symptoms disappeared after symptomatic treatment. [ Conclusion ] The therapy of integrated traditional Chinese and Western Medicine has a certain therapeutic effect on HAVD. The appropriate mental nursing may enhance the treatment compliance of patients, while the comprehensive nursing measures can effectively promote patients＂ recovery, and improve their quality of life.