中药汤剂湿敷预防穿刺性静脉硬化的临床研究

Clinical study of preventive effect of traditional Chinese medicine wet compress on vein puncture sclerosis

目的 探讨自拟中药汤剂湿敷对穿刺性静脉硬化的影响.方法 选择接受静脉给药治疗的患者180例,采用随机数字表法分为A组、B组和C组各60例.A组在常规静脉输液操作后于穿刺点上方沿血管走向用中药汤剂（大黄20 g、玄明粉20 g、黄柏15 g、马齿苋20 g煎制而成）将8层10 cmx5 cm无菌纱布浸湿湿敷,然后用塑料保鲜膜包盖至输液结束30 min后取下;B组在静脉输液结束时于穿刺点上方沿血管走向用中药汤剂将8层10 cmx5 cm无菌纱布浸湿湿敷,然后用塑料保鲜膜包盖6 h后取下;C组常规静脉输液操作无湿敷干预.分别于3 d、5 d观察评估各组静脉弹性,正常为有效,轻、中、重度硬化为无效.结果 A组湿敷3 d、5 d有效率分别为100.0%、91.7%,B组3 d、5 d有效率分别为100.0%、81.7%,A组与B组比较5 d有效率差异有统计学意义（x2=5.17,P〈0.05）;C组3 d、5 d有效率分别为71.7%、60.0%,与A、B组5 d有效率比较差异均有统计学意义（x2=21.07、6.82,均P〈0.01）.结论 静脉输液过程中局部予中药汤剂湿敷预防穿刺性静脉硬化效果显著,且操作简便,无毒副反应,易于患者接受,值得临床推广应用.

Objective To investigate the effect of self decoction wet compress on puncture venous sclerosis.Methods 180 patients received intravenous therapy,they were randomly divided into group A,group B and group C,60 cases in each group.Group A was given with Traditional Chinese medicine decoction（rhubarb 20g,Xuan Ming powder 20g,Cortex Phellodendri 15g,20g purslane fried together） for in the direction of blood vessel along the direction of the blood vessel after operation of conventional intravenous infusion,8 layer 10cm＆#215;5cm sterile gauze soaked wet,then covered with plastic wrap plastic to the end of infusion 30 min after removal.Group B was given with Traditional Chinese medicine decoction at the end of intravenous infusion at the puncture point along the direction of the blood vessels,8 layer 10cmx5cm sterile gauze soaked wet and then with plastic wrap plastic cover 6h after removing.Group C was given with routine intravenous infusion operation without wet compress intervention.In 3d,5d,vein elasticity of each group was assessed,the normal was effective,mild,moderate and severe hardening was invalid.Results After 3d,5d treatment,the effective rates of group A were 100.0%,91.7% respectively,which in group B were 100.0%,81.7%,respectively,the effective rate at 5d had statistically significant difference between group A and group B （x2=5.17,P〈0.05）;after 3d,5d treatment,the effective rates of group C were 71.7%,60.0%,and the effective rate at 5 d had statistically significant difference compared with group B and group A （x2=21.07,6.82,all P〈0.01）.Conclusion The effect of intravenous infusion process to local decoction wet compress on the prevention of venous puncture hardening is significant,and the method is simple,has non-toxic side effects,it is worthy of clinical application.