不同部位皮下注射依那西普患者的疼痛程度及皮肤红斑情况

Degree of Pain and Incidence of Erythema of Patients with Subcutaneous Injection of Etanercept at Different Site

目的比较不同部位皮下注射依那西普患者疼痛程度及皮肤红斑情况,以期为选择最适合的注射部位以减轻患者疼痛、减少不良反应提供临床依据。方法 2015年1-12月,便利抽样法选取在哈尔滨医科大学附属第一医院风湿免疫科住院治疗的风湿病患者122例为研究对象。所有患者均需皮下注射依那西普,注射部位为左右上臂的外侧区域、腹部左右侧及左右大腿中部前侧,注射剂量为25 mg/次。比较上述6个部位注射时患者的疼痛程度及红斑发生情况。结果患者左上臂、右上臂、腹部左侧、腹部右侧、左大腿中部、右大腿中部注射数字疼痛分级法(numeric pain intensity scale,NPIS)评分分别为(2.94±2.34)、(2.91±2.20)、(1.86士1.89)、(1.90±1.99)、(4.13±2.69)、(4.05士2.62)分,差异有统计学意义(P<0.05)。左上臂、右上臂、腹部左侧、腹部右侧、左大腿中部、右大腿中部注射部位皮肤红斑发生率分别为8.20%、8.20%、4.10%、4.10%、14.75%、13.93%,差异有统计学意义(P<0.05)。左大腿中部、右大腿中部注射NPIS评分及注射部位皮肤红斑发生率均高于腹部左侧、腹部右侧、左上臂、右上臂注射,差异均有统计学意义(均P<0.05);且左上臂、右上臂注射NPIS评分及注射部位皮肤红斑发生率均高于腹部左侧、腹部右侧注射,差异均有统计学意义(均P<0.05)。结论腹部皮下注射可减轻患者疼痛程度,并减少皮肤红斑的发生率,值得临床推广。

Objective To compare the degree of pain and incidence of erythema of the patients with subcutaneous injection of Etanercept at different site, in order to provide clinical evidence in selecting the best injection site to reduce the degree of pain and lower the incidence of adverse reactions.Methods Totally 122 patients were selected randomly. All cases were given Etanercept injection of 25mg each time at different injection site, including left and right side of lateral upper arm, abdomen and anterior mid-thigh. The degree of pain and incidence of erythema at those sites were observed and compared after injection.Results The NPIS score in left upper arm, right upper arm, left side of abdomen, right side of abdomen, left mid-thigh and right mid-thigh were（2.94±2.34）, （2.91±2.20）, （1.86±1.89）, （1.90± 1.99）, （4.13± 2.69） and（4.05±2.62）, respectively （P〈0.05）. The incidence rate of erythema in the site of left upper arm, right upper arm, left side of abdomen, right side of abdomen, left mid-thigh and right mid-thigh were 8.20%,8.20%,, 4.10%, 4.10%, 14.75% and 13.93%, respectively （P〈0.05）. The NPIS score and incidence rates of erythema in the site of right side of abdomen and left mid-thigh were higher than left side of abdomen, right side of abdomen, left upper arm and right upper arm （all P〈0.05）. The NPIS score and incidence rates of erythema in left upper arm and right upper arm were higher than left side of abdomen and right side of abdomen （all P〈0.05）.Conclusion Subcutaneous injection in abdominal wall can reduce the degree of pain and incidence of erythema, which is worth for clinical promotion.