盐酸奥布卡因凝胶对糖尿病足肌筋膜间隙感染患者对口引流术后换药的止痛效果观察

Effect of oxybuprocaine hydrochloride gel on pain of counterpart drainage and dressing in patients with myofascial space infection of diabetic foot

目的观察盐酸奥布卡因凝胶对糖尿病足肌筋膜间隙患者感染采用对口引流术后换药时的止痛效果。方法选取2015年1月1日至2017年12月31日于首都医科大学宣武医院伤口护理中心就诊的糖尿病足肌筋膜间隙感染患者200例,随机分为2组,每组各100例,均实施小切口对口引流术。换药前对照组用0.9%氯化钠溶液冲洗切口,而未使用局部麻醉,采用新型湿性愈合敷料;观察组在对照组基础上,切口注入盐酸奥布卡因凝胶作用4min。采用数字评定量表(numerical rating scale,NRS)和笑脸评分(语言障碍患者)评价2组患者疼痛程度并对比分析切口愈合时间。结果治疗组NRS和笑脸评分,优79例,良12例,中6例,差3例;对照组NRS和笑脸评分,优6例,良21例,中33例,差40例;2组间比较,差异具有统计学意义(χ^2=936.0,P<0.05)。观察组WagnerⅢ和Ⅳ级伤口愈合时间为(35.40±3.72)和(91.07±19.55)d,分别短于对照组的(36.32±3.09)d和(92.22±18.73)d,但差异无统计学意义(P>0.05)。结论盐酸奥布卡因凝胶在糖尿病足肌筋膜间隙感染患者采用对口切开引流术后换药时,对患者疼痛的管理具有重要作用。

Objective:To explore the clinical application of oxybuprocaine hydrochloride gel in pain of counterpart drainage and dressing in patients with myofascial space infection of diabetic foot Methods;From January 1,2015 to December 31,2017,200 patients with myofascial space infection of diabetic foot admitted in Wound Care Center of Xuanwu Hospital selected.All the patients were divided into two groups randomly,with100 patients in each group.They underwent counterpart drainage and dressing with small incisions.Before dressing,the incision in the control group was rinsed with 0.9% sodium chloride solution and new-style wet healing dressing,while local anesthetics were not used.The observation group was injected with oxybuprocaine hydrochloride gel for 4 min on the basis of the control group.The degree of pain in the two groups was evaluated by numerical rating scale(NRS) and the smiley score(for patient with speech impairment),and the healing time of the incision was compared and analyzed.Results:In the observation group,there were 79 excellent cases,12 good cases,6 moderate cases,3 poor cases;while in the control group,there were 6 excellent cases,21 good cases,33 moderate cases,40 poor cases.The difference in the two groups was statistically significant(χ~2=936.0,P<0.05).There was no significant difference in the healing time between the two groups.The healing time of Wagner Ⅲ and Ⅳ wounds in the observation group was(35.40±3.72) and(91.07±19.55) d,shorter than(36.32±3.09) and(92.22±18.73) d in the control group respectively,however,there was no significant difference(P> 0.05).Conclusion:Oxybuprocaine hydrochloride gel plays an important role in managing pain of counterpart drainage and dressing in patients with myofascial space infection of diabetic foot.