黄连膏预防儿童克氏针针道感染的临床研究

Clinical research on the prevention of Kirschner wire tract infection in children with Huanglian ointment

目的探讨黄连膏预防儿童克氏针针道感染的临床效果,以期为临床相关治疗提供参考。方法本研究选取重庆市中医骨科医院2023年1月—2024年1月收治的60例骨折患儿为研究对象。采用随机数字表法将患儿分为对照组和治疗组,每组30例。对照组患儿采用75%医用酒精进行针道换药,治疗组患儿采用黄连膏进行针道换药。采用Checketts-Otterburn8感染分级对患儿感染情况进行评定;术后4周采用视觉模拟量表(VAS)评估患儿疼痛程度;比较2组患儿术后拔除克氏针的时间,以影像学形成稳定骨痂为拔针标准;观察并记录患儿用药期间的不良反应发生情况。结果治疗组患儿感染率(13.33%)低于对照组(40.00%),差异具有统计学意义(P<0.05)。2组患儿不同时期VAS评分比较,差异有统计学意义(P<0.05)。第2、3、4周时,2组患儿VAS评分均低于第1周,且随着时间的延长,2组患儿VAS评分均呈下降趋势,差异有统计学意义(P<0.05)。治疗组患儿不同时期VAS评分均低于对照组,差异均有统计学意义(P<0.05)。治疗组患儿拔除克氏针时间(39.33±4.43)d,对照组拔除克氏针时间(40.60±6.36)d。2组患儿拔除克氏针时间差异无统计学意义(P>0.05)。所有患儿发生的不良反应均未做特殊处理,自主痊愈,且2组患儿不良反应发生率差异无统计学意义(P>0.05)。结论黄连膏作为中医传统外用药物能够有效预防儿童骨折术后外置克氏针针道感染,在初期能明显降低患儿的痛觉,不影响拔除克氏针时间,且未出现任何不良反应,为预防针道感染提供了新方向。

Objective This study aimed to investigate the clinical efficacy of Huanglian Ointment in preventing Kirschner wire tract infection in children,in order to provide a reference for related clinical treatments.Methods A total of 60 pediatric patients with fractures admitted to Chongqing Traditional Chinese Medicine Orthopedic Hospital between January 2023 and January 2024 were selected as the study participants.The patients were randomly assigned to control group or treatment group,with 30 cases in each group.The control group received 75%medical alcohol for Kirschner wire tract dressing changes,and the treatment group received Huanglian Ointment for the.Infection status was assessed using the Checketts-Otterburn infection grading system.Pain levels were evaluated using the Visual Analog Scale(VAS)4 weeks after operation.The time for Kirschner wire removal oper ation,determined by the formation of stable callus on imaging,was compared between the two groups.Adverse reactions during the medication period were observed and recorded.Results The infection rate in the treatment group was significantly lower than that in the control group(13.33%vs.40.00%;P<0.05).Significant differences were found in VAS scores between the two groups at different time points(P<0.05).At the 2nd,3rd,and 4th weeks,VAS scores for both groups were lower than at the 1st week,and showed a decreasing trend over time,with significant differences(P<0.05).The treatment group had consistently lower VAS scores than the control group at all time points,with significant differences(P<0.05).The Kirschner wire removal time for the treatment group was(39.33±4.43)days,and for the control group was(40.60±6.36)days,without statistically significant differences(P>0.05).All adverse reactions in both groups resolved spontaneously without special treatment,and no statistically significant difference was noted in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Huanglian Ointment,a traditional Chinese external medication,effectively prevents Kirschner wire tract infections in pediatric fracture patients postsurgery.It markedly reduces pain in the early stages without affecting the Kirschner wire removal time and did not cause any adverse reactions,providing a new perspective for the prevention of Kirschner wire tract infections.