中药敷贴预防兔骨外固定支架针孔感染的效果

Experimental study on infection prevention of pinhole in external fixation of rabbits with traditional Chinese Medicine

目的构建大耳白兔胫骨外固定模型,应用新型中药敷贴护理方法对兔骨外固定支架针孔进行护理,以论证新型中药敷贴的有效性及可行性,为临床护理提供理论依据。方法选用5~7个月月龄的新西兰大耳白兔作实验对象,共30只,体重2.5~3.0 kg,并适应性喂养1周。建立兔骨外固定支架模型,采用中药配方:天花粉100 g,大黄100 g,骨碎补100 g,自然铜100 g,黄柏60 g,血竭20 g,甘草20 g。按照制作创可贴的工艺和流程制作5 cm×3 cm中药敷贴。按随机排列表法将造模好的大耳白兔分为5组,每组6只。实验组为新型中药敷贴护理组,分为A1组与A2组,对照组为75%乙醇护理组(B组)、碘伏护理组(C组)、零护理组(D组),每组6只。其中A1组每3 d更换敷料1次,A2组延长更换敷料时间至每7 d 1次,B、C和D组均按每3 d更换敷料1次,有渗血渗液则及时更换敷料。通过检测血白细胞(WBC)计数及降钙素原(PCT)含量并观察针孔处局部情况进行效果评价。结果 A1组耳缘静脉血WBC计数和PCT含量在术后第7天、第14天均明显低于B、C及D组,差异有统计学意义(P<0.05);A1与A2组间比较,差异无统计学意义(P>0.05);A1组与A2组发生红肿率均为33.33%,C、D两组均为50%,B组为100%;部分存在脓液外渗等现象,穿针处皮肤周围有黄色分泌物,周围组织部分溃疡坏死,A1组分泌物发生率为16.67%,A2组为0,B组为66.67%,C、D两组均为33.33%。结论新型中药敷贴具有消肿止痛、止血生肌的功效,在预防兔骨外固定支架针孔感染中的效果显著,且优于临床上传统针孔护理方法,为进一步临床护理试验提供了动物实验依据。

Objective To establish a bone external fixation model of white rabbits,and to use a new type of Chinese medicine application care method to treat the pinholes of external fixation;thus to evaluate for efficacy and feasibility of the new Chinese medicine application for clinical nursing. Methods New Zealand white rabbits aged 5-7 months were selected as the experimental subjects. A total of 30 rabbits weighing approximately 2. 5-3. 0 kg were fed with the diet for one week. A rabbit external fixator model was established. According to the Chinese medicine prescription,the traditional Chinese medicine ( TCM) formula with antiphlogistic,analgesic and hemostatic myogenic,a 5 cm* 3 cm TCM applicator was made as band-aid. The rabbits were divided into 5 groups according to the random row method. The experimental groups were divided into Group A1 and A2. The rabbits in Group B,C and D were treated with 75% alcohol, iodophor,and zero nursing group,respectively. The dressing was changed in every 3 days in Group A1,so were in Group B,C and D. The dressing was changed every 7days in Group A2. The WBC count and PCT content were recorded,and the local condition of the pinhole was also observed. Results WBC count and PCT content in Group A1 were significantly lower than those in Group B,C and D on the 7th and 14th days after operation ( P < 0. 05);while there was no significant difference between Group A1 and A2 ( P > 0. 05). Inflammation rate were both 33. 33% in the Group A1 and A2. The infection rates were 50% in Group C and D,and 100% in Group B. There was a phenomenon such as pus extravasation, and the skin around the needle was yellow secretions. The peripheral tissues were partially ulcerated and necrotic. The rates of secretion in the Group A1,A2,B,C and D were 16. 67%,0%,66. 67%,33. 33% and 33. 33%,respectively.Conclusion The new TCM application alleviates swelling and pain,and improves hemostasis and myogenic activity. It is effective in prevention of pinhole infections in rabbits with external fixators,and superior to clinical traditional pinhole care methods.