复方利多卡因乳膏用于糖尿病足溃疡患者换药的临床观察

Effect of Compound Lidocaine Cream for dressing in patients with diabetic foot ulcers

目的观察复方利多卡因乳膏用于糖尿病足溃疡(DFU)患者换药的效果。方法选择2017年1月至2018年3月在深圳市人民医院拟行换药的DFU患者60例,采用随机数表法分为对照组和观察组,每组30例。观察组换药前1 h使用1g复方利多卡因乳膏涂抹患处,用敷料覆盖,对照组直接用敷料覆盖。记录换药时间、伤口愈合时间、换药前(T0)、换药时(T1)及换药后1 h (T2)的平均动脉压(MAP)和HR,使用视觉模拟评分(VAS)对T1和T2时点的疼痛进行评分,记录换药期间高血压的发生率,换药结束后进行满意度评价。结果对照组患者T1、T2时点的MAP [(108.3±12.6) mmHg,(101.4±8.2) mmHg]、HR [(91.2±10.3)次/min,(83.8±7.5)次/min]高于同时点观察组的MAP [(93.3±9.2) mmHg,(90.1±7.5) mm Hg]和HR [(80.2±8.8)次/min,(79.3±7.2)次/min],差异均有统计学意义(P<0.05);对照组患者T1、T2时点的VAS [(6.3±1.5)分,(3.2±1.1)分]高于观察组[(1.3±0.6)分,(1.1±0.3)分],伤口愈合时间为(25.4±8.4) d,长于观察组的(20.3±9.1) d,高血压发生率为40.0%,高于观察组的10.0%,差异均有统计学意义(P<0.05);观察组患者对换药满意度为90.0%,高于对照组的26.7%,差异有统计学意义(P<0.05)。结论复方利多卡因乳膏用于DFU患者换药,可减轻患者疼痛,稳定血流动力学,促进伤口愈合,提高患者满意度。

Objective To observe the effect of Compound Lidocaine Cream for dressing in patients with diabetic foot ulcers （DFU）. Methods A total of 60 patients with DFU were randomly divided into control group and observation group by random number table, with 30 cases in each group. Patients in the observation group was smeared with 1 g Compound Lidocaine Cream 1 hour before dressing change, while the patients in the control group applied the dressing directly. The dressing time and wound healing time were recorded. Mean arterial pressure （MAP） and heart rate （HR） were also determined before dressing （TO）, at the dressing （T1）, 1 h after dressing （T2）. Visual Analogue Scale （VAS） was used to assess pain level at T1 and T2. Satisfaction of patients was evaluated after dressing. Results In the observation group, MAP, HR were （108.3±12.6） mmHg, （91.2±10.3） beats/rain at T1, （101.4±8.2） mmHg, （83.8±7.5） beats/min at T2, versus （93.3±9.2） mmHg, （80.2±8.8） beats/min at T1 and （90.1±7.5） mmHg, （79.3±7.2） beats/min at T2 in the control group （P〈0.05）. The VAS of T1 and T2 were （6.3±1.5） and （3.2±1.1） respectively in control group, versus （1.3±0.6） and （1.1±0.3） respectively in the observation group （P〈0.05）. The wound healing time was （25.4±8.4） days in the control group, significantly longer than （20.3±9.1） days in the observation group （P〈0.05）. The incidence of hypertension showed statistically significant differences between the control group （40.0%） and the observation group （10.0%）, P〈 0.05. Satisfaction rate was 90.0% in the observation group, significantly higher than 26.7% of the control group （P〈 0.05）. Conclusion Compound Lidocaine Cream used for dressing in patients with DFU can relieve pain, maintain stable hemodynamics, promote wound healing and improve satisfaction.