酚妥拉明局部封闭联合活血消肿膏治疗多巴胺外渗组织损伤的临床研究

Clinical Study of Phentolamine Partial Occlusion Combined with Huoxuexiaozhong Ointment in the Treatment of Dopamine Extravasation Tissue Damage

目的探究酚妥拉明早期局部封闭联合活血消肿膏治疗因多巴胺外渗所导致的局部组织损伤的治疗作用及效果。方法收集青岛市3所三级甲等医院重症监护室2020年7月—2022年7月经外周静脉泵入多巴胺发生外渗引起组织损伤的患者80例,应用随机数表法将患者分为干预组(活血消肿膏组)和对照组(50%硫酸镁组),每组40例。两组患者采用相同的局部封闭方法,干预组应用活血消肿膏外敷,对照组采用50%硫酸镁外敷,每4小时更换敷料1次,每8小时观察两组治疗效果,患者出院或死亡时对其组织损伤程度再次进行评估,比较两组患者治疗后的美国食品和药品管理局(FDA)皮肤损伤评分,并进行多元线性回归分析。结果干预组多巴胺外渗治疗后的FDA皮肤损伤评分显著低于对照组,差异有统计学意义(P<0.05),多元线性回归分析的结果显示活血消肿膏降低FDA皮肤损伤评分的效果是50%硫酸镁的2.85倍,临床效果显著。结论酚妥拉明早期局部封闭联合活血消肿膏治疗多巴胺外渗组织损伤,可显著降低外渗皮肤出现炎症及坏死的发生率。

Objective To explore the therapeutic effect of phentolamine early local closure combined with Huoxuexiaozhong ointment in the treatment of local tissue damage caused by dopamine extravasation.Methods A total of 80 patients with tissue damage caused by extravasation of dopamine through peripheral intravenous pumping were collected from July 2020 to July 2022 in the intensive care units of 3 hospitals in Qingdao.These patients were randomly divided into an intervention group(Huoxuexiaozhong ointment group,40)and a control group(50%magnesium sulfate group,40).The two groups of patients were treated with the same partial sealing method.The intervention group was applied with external application of Huoxuexiaozhong ointment.The control group was use to external application 50%magnesium sulfate.Change the dressing every 4 h/time.We observed the therapeutic effect of the two groups every 8 hours.The degree of tissue damage was reassessed until they are discharged or died,and the US Food and Drug Administration(FDA)skin damage scores were compared between the two groups after treatment,and carry out multiple linear regression analysis.Results The FDA score of the intervention group was significantly lower than that of the control group(P<0.05).The results of multiple linear regression analysis showed that the ability of Huoxuexiaozhong ointment can reduce the FDA skin damage score was 2.85 times that of 50%magnesium sulfate,and the clinical effect was significant.Conclusion Early partial closure of phentolamine combined with Huoxuexiaozhong ointment in the treatment of dopamine extravasation tissue damage can significantly reduce the incidence of infl ammation and necrosis of extravasated skin.