硫酸镁联合山莨菪碱低温湿敷减轻阿奇霉素所致疼痛及静脉炎

目的 探讨硫酸镁联合山莨菪碱低温湿敷减轻输注阿奇霉素所致疼痛和静脉炎的效果.方法 将输注阿奇霉素引起局部疼痛住院患儿120例随机均分为A、B、C三组各40例,于输注阿奇霉素前5～10 min,A组采用0℃湿纱布、B组采用18～22℃2%利多卡因纱布、C组采用O℃30%硫酸镁加2%山莨菪碱纱布,沿患儿血管走向在穿刺点上方3～5 cm近心端处湿敷,直至阿奇霉素输注完毕.结果 C组镇痛效果显著优于A、B组(均P＜0.0125),静脉炎严重程度最低(P＜0.01).结论 硫酸镁联合山莨菪碱低温湿敷可减轻输注阿奇霉素引起患儿局部疼痛,减轻静脉炎严重程度.     

局部封闭加硫酸镁湿敷治疗甘露醇所致静脉炎的效果观察

目的 探讨局部封闭加硫酸镁湿敷治疗甘露醇所致静脉炎的效果。方法 将73例静脉滴注甘露醇所致静咏炎（均为Ⅲ度）患者随机分为两组．对照组（37例）给予50％硫酸铗湿敷，观察组（36例）给予2％利多卡因5ml加地塞米松5mg加0．9％氯化钠注射液10ml局部环型封闭后再行50％硫酸镁湿敷，24h后观察两组患者静脉炎治疗效果．结果 观察组疗效显著优于对照组（P〈0．01）。结论 局部环型封闭后用50％硫酸镁湿敷处理甘露醇所致静脉炎疗效显著。     

复合溶菌酶纱布湿敷预防化疗性静脉炎

目的探讨复合溶菌酶杀菌纱布湿敷减轻输注化疗药物所致疼痛及静脉炎的效果。方法将输注化疗药物的120例患者分为观察组和对照组各60例。对照组在开始输入化疗药时用4层16cm×7cm长方形无菌纱布浸透50%硫酸镁溶液湿敷,用保鲜膜包裹后胶布固定;观察组在开始输入化疗药时用4层复合溶菌酶杀菌纱布1块(14cm×7cm)湿敷,用透明敷贴覆盖固定。结果两组静脉炎发生率、静脉炎程度、疼痛程度比较,差异有统计学意义(均P0.01)。结论复合溶菌酶杀菌纱布湿敷能有效降低化疗性静脉炎发生率,镇痛效果好。     

消炎镇痛膏外贴治疗静脉炎的疗效观察

目的 探讨消炎镇痛膏外贴治疗静脉炎的效果。方法 将88例化疗后发生静脉炎患者随机分为对照组与观察组各44例，观察组用消炎镇痛膏外贴患处，对照组采用50％硫酸镁溶液湿敷。结果 观察组总有效率为100％，对照组为72．8％，两组比较，差异有显著性意义（P〈0．01）。结论 采用消炎镇痛膏外贴可治疗静脉炎引起的局部组织红肿疼痛，且疗效显著。     

马黄酊湿敷治疗化疗性静脉炎效果观察

目的探讨马黄酊湿敷治疗化疗性静脉炎的效果。方法将74例化疗性静脉炎患者随机分为观察组和对照组各37例。观察组局部应用马黄酊湿敷。对照组采用50％硫酸镁溶液湿敷。结果观察组治疗效果显著优于对照组（P〈0．05）。结论马黄酊治疗化疗性静脉炎疗效满意，是治疗化疗性静脉炎的有效方法之一。     

利多卡因山莨菪碱联合芦荟喜疗妥防治盖诺所致静脉炎

目的探讨防治盖诺静脉注射所致静脉炎的有效方法。方法将84例非小细胞肺癌患者按随机数字表法分为对照组（41例）和观察组（43例）。对照组化疗过程中沿血管走行涂喜疗妥软膏防治静脉炎；观察组采用2％利多卡因加山莨菪碱湿敷预防静脉炎，用芦荟与喜疗妥昼夜交替使用治疗静脉炎。1个疗程后评价防治效果。结果观察组静脉炎发生率及严重程度显著低于对照组（均P〈0．01），静脉炎治疗效果显著优于对照组（P〈0．01）。结论利多卡因与山莨菪碱湿敷联合喜疗妥与芦荟交替使用防治化疗性静脉炎效果显著。     

频谱仪照射辅助治疗外周静脉置管局部肿胀效果观察

将经外周静脉置管致局部肿胀的 6 5例病人随机分为A(35例 )、B(30例 )两组 ,A组用 5 0 %硫酸镁湿敷联合频谱仪照射 ,B组仅用 5 0 %硫酸镁湿敷。结果A组护理效果明显优于B组 (P <0 .0 5 )。提示用 5 0 %硫酸镁湿敷联合频谱仪照射能明显消除置管所致局部肿胀。     

硫酸镁湿敷联合压力疗法治疗止血带压迫所致肿胀的效果观察

目的寻找更有效的方法治疗术中止血带压迫所致的局部肿胀、疼痛、水疱。方法将90例患者随机分成A,B,C三组,每组30例。A组：硫酸镁湿热敷;B组：弹力绷带加压包扎;C组：硫酸镁湿热敷外加弹力绷带加压。观察并记录肿胀及疼痛的消退情况。结果C组患者肿痛消退快,恢复好,取得明显疗效（P〈0．05）。结论外加适当压力的硫酸镁湿热敷可以更快速有效地消除因局部长时间受压所导致的局部组织肿胀,减轻疼痛,从而减轻患者的痛苦,提高患者的生活质量。     

芦荟湿敷缓解静脉补钾局部疼痛的观察

选取含 0 .0 3%氯化钾的葡萄糖或葡萄糖氯化钠注射液静脉滴注时引起的局部重度疼痛的病人 10 5例 ,随机分为A、B、C三组 ,各 35例 ,A组予鲜芦荟湿敷疼痛部位 ;B组予生理盐水湿敷 ;C组不作处理。结果三组比较 ,P <0 .0 1,差异有显著性意义 ;A、B组比较 ,前者疼痛程度低于后者 ,差异有显著性意义 (P <0 .0 5 ) ,芦荟及生理盐水湿敷均能使局部疼痛减轻或消失 ,但芦荟湿敷效果优于生理盐水。提示芦荟湿敷是缓解静脉补钾引起局部疼痛较好的方法。     

乙醇加镇痛消炎软膏外敷治疗患儿输液外渗

目的 寻求治疗儿童输液外渗的简便、有效方法。方法 将248例输液外渗的患儿随机分为观察组和对照组各124例。观察组发生输液外渗后即用30％乙醇加镇痛消炎软膏敷于肿胀部位，纱布包扎，胶布固定；对照组采用50％硫酸镁溶液湿敷。结果 治疗24h观察组局部肿胀完全消退率及疼痛完全缓解率显著高于对照组（均P〈0．01）。结论乙醇加镇痛消炎软膏用于患儿输液外渗后外敷安全、有效，使用方便，患儿舒适，药物保留时间长。     

富林密凝胶对静脉炎防治的护理研究

目的研究富林密凝胶在静脉炎防治中的应用,探讨一种能够尽量缓解患者疼痛及疼痛持续时间,使用方便又无副作用的治疗静脉炎的护理方法。方法依据美国静脉输液护理学会对静脉炎的诊断标准,我们选取120病例,按住院号后两位数字单双数,随机分成两组,实验组60例采用富林密凝胶顺静脉走行外敷,对照组60例采用50%硫酸镁湿敷。结果实验组患者的疼痛缓解时间是（1.68±0.42）h,对照组患者的疼痛缓解时间是（2.51±0.81）h,实验组患者的疼痛缓解时间要明显短于对照组,差异有统计学意义（t=2.35,P〈0.05）;实验组患者的治疗效果要高于对照组,但差异无统计学意义（χ^2=4.39,P〉0.05）;出院时,实验组患者的满意度评分要明显高于对照组,差异有统计学意义（t=2.41,P〈0.05）。结论富林密凝胶可有效改善局部疼痛,缩短疼痛缓解时间,可有效保护血管,并且方便地涂于患处,解决了湿敷时的不便。     

硫酸镁对气管插管时血流动力学和应激激素浓度的影响

目的:以脑电双频指数(BIS)作为麻醉深度监测指标,研究靶控输注丙泊酚时不同剂量的硫酸镁对气管插管时血流动力学和应激激素浓度变化的影响,以及对丙泊酚效应室靶浓度的影响。方法:60例择期手术病人随机分为C组、M1组和M2组,每组20例。以靶控输注丙泊酚行麻醉诱导(初始靶浓度为2μg/mL),M1组和M2组在气管插管前3min分别静脉推注硫酸镁15、25mg/kg;并根据BIS值变化调节3组丙泊酚靶浓度,使BIS值在45～55范围内。结果:C组的SBP、MBP在插管后即刻和1min较基础值明显升高(P0.01),M1、M2组变化不明显(P0.05)。C组血浆Cor浓度在插管后3min时明显上升(P0.05),而M1、M2组呈下降趋势(P0.05)。C组血浆A-Ⅱ浓度在插管后3、10min时明显上升(P0.05),与M1组、M2组相比差异显著(P0.05)。C组在插管后5、10min丙泊酚靶有效浓度显著高于M1组和M2组(P0.01);M2组在同一时点低于M1组(PO.O5)。结论:与15mg/kg硫酸镁组相比,25mg/kg硫酸镁组能更好地减轻气管插管引起的应激反应,并且明显降低丙泊酚TCI效应室靶浓度,减少丙泊酚用量。     

早期电动磨痂结合不同种敷料覆盖修复小儿深Ⅱ度烧伤创面的疗效观察

目的：观察小儿深Ⅱ度烧伤创面早期电动磨痂后结合不同种敷料覆盖的治疗效果.方法：将2010年1月-2012年1月收治的60例四肢和躯干热液烫伤患儿随机分为凡士林油纱组、生物敷料组和负压封闭引流（VSD）组,每组20例.各组患儿在磨痂后,根据分组的不同,分别应用凡士林油纱、异种脱细胞真皮基质或VSD覆盖创面.术后观察创面愈合时间、愈合质量、换药次数、治疗费用.结果：生物敷料组、VSD组的创面愈合时间分别为（16.3±1.9）d和（16.9±1.8）d,明显短于凡士林纱布组[（19.2±2.5）d,P＜0.05];生物敷料组、VSD组反映瘢痕增生程度的温哥华评分分别为（4.5±0.7）分和（4.1±0.8）分,明显低于凡士林油纱组[（8.6±1.2）分,P＜0.01];VSD组的换药次数[（3.0±0.5）次]明显低于凡士林油纱组[（6.9±0.7）次,P＜0.05]和生物敷料组[（7.2±0.8）次,P＜0.01];凡士林油纱组的住院费用[（6 560.34±1 230.00）元],明显低于生物敷料组[（12 028.24±1 380.00）元,P＜0.01]和VSD组[（14 125.40±1 560.00）元,P＜0.01].结论：早期磨痂应用异种生物敷料和VSD覆盖较普通油纱覆盖能明显促进小儿深Ⅱ度烧伤创面愈合,缩短住院时间,显著提高创面愈合质量,减少换药次数,减轻患儿痛苦,但住院费用较高,临床上应根据患儿具体情况,灵活选择磨痂后创面覆盖物.     

Magnesium sulfate does not reduce postoperative analgesic requirements

BACKGROUND: Because magnesium blocks the N-methyl-D-aspartate receptor and its associated ion channels, it can prevent central sensitization caused by peripheral nociceptive stimulation. However, transport of magnesium from blood to cerebrospinal fluid (CSF) across the blood-brain barrier is limited in normal humans. The current study was designed to evaluate whether perioperative intravenous magnesium sulfate infusion affects postoperative pain. METHODS: Sixty patients undergoing abdominal hysterectomy received 50 mg/kg intravenous magnesium sulfate as a bolus dose followed by a continuous infusion of 15 mg x kg(-1) x h(-1) for 6 h (magnesium group) or the same volume of isotonic saline (control group). At the end of surgery, serum and CSF magnesium concentration were measured in both groups. The cumulative postoperative analgesic consumption was measured to assess the analgesic effect using a patient-controlled epidural analgesia device. Pain intensities at rest and during forced expiration were evaluated at 6, 24, 48, and 72 h postoperatively. RESULTS: At the end of surgery, patients in the magnesium group had significantly greater postoperative serum magnesium concentrations compared with both preoperative and control group values (P < 0.001). Despite significantly higher serum magnesium concentrations in the magnesium group, there was no significant difference in magnesium concentration measured in postoperative CSF. Cumulative postoperative analgesic doses were similar in both groups. However, there was observed an inverse relation between cumulative postoperative analgesic consumption and the CSF magnesium concentration in both groups. Visual analog pain scores at rest and during forced expiration were similar and less than 4 in both groups. CONCLUSIONS: Perioperative intravenous administration of magnesium sulfate did not increase CSF magnesium concentration and had no effects on postoperative pain. However, an inverse relation between cumulative postoperative analgesic consumption and the CSF magnesium concentration was observed. These results suggest that perioperative intravenous magnesium infusion may not be useful for preventing postoperative pain.     

不同敷料对深度烧伤创面植皮后愈合情况的影响对比

目的:对比分析不同敷料对深度烧伤创面植皮后愈合情况的影响。方法:选取我院于2011年5月～2012年5月收治的69例深度烧伤并接受创面植皮的患者,选择患者身上2处大小为1%的邻近创面,将创面内层覆盖物为聚酰胺薄纱的所有创面作为实验组,内层覆盖物为凡士林油纱的创面作为对照组。对比分析两组术后的创面蒸发量、不同时间点的创面愈合率、创面愈合时间及换药时的疼痛情况。结果:术后5天,实验组内层敷料表面的蒸发量要明显少于对照组[(25.3±6.1)ml.h-.1m-2vs(35.8±4.9)ml.h-.1m-2t=11.147 P<0.05],所有患者内层敷料表面的蒸发量要显著少于裸露创面(P<0.05),但高于正常皮肤表面(P<0.05);实验组术后10天,15天及20天的创面愈合率均高于对照组[(81.2±19.5,95.3±9.4,99.8±0.4)%vs(72.4±7.6,84.6±10.4,97.2±2.3)%t=3.493,6.340,9.251 P<0.05],且创面完全愈合时间要显著短于对照组[(14.1±2.0)天vs(17.2±2.5)天t=8.043 P<0.05];实验组术后5天换药及揭除内层敷料时的VAS评分要明显低于对照组[(3.3±0.7,5.0±0.6)vs(4.9±0.4,7.9±0.5),t=16.485,30.843 P<0.05]。结论:相比与传统的凡士林油纱,聚酰胺薄纱更有利于深度烧伤创面植皮后的愈合,且减轻了患者换药时的疼痛,值得推广。     

Role of magnesium sulfate in postoperative pain management for patients undergoing thoracotomy

OBJECTIVE: The purpose of this study was to investigate the effect of magnesium sulfate on pain management for post-thoracotomy patients. DESIGN: A prospective, randomized, controlled clinical study. SETTING: University hospital. PARTICIPANTS: Twenty-four patients undergoing thoracotomy. INTERVENTIONS: After thoracotomy operations, patients were assigned to 2 groups. The control group received intravenous morphine (0.5 mg/h infusion, 0.3 mg patient-controlled anesthesia dose, 15-minute lockout time) via patient-controlled analgesia, and the magnesium group received magnesium sulfate (30-mg/kg bolus, 10 mg/kg/h infusion for 48 hours) plus the same patient-controlled analgesia protocol. MEASUREMENTS AND MAIN RESULTS: Visual analog scale for pain score, sedation score, mean arterial pressure, heart rate, and valid and invalid analgesic demand were recorded. Serum magnesium levels were determined at postanesthesia care unit admission, at 24 hours, and at 48 hours. Side effects were also recorded. There were no significant differences between groups with respect to demographics, sedation score, and pain score. Cumulative mean morphine consumption was found to be higher in the control group compared with the magnesium group at 4, 8, and 48 hours (5.6 +/- 1 mg v 3.2 +/- 0.6 mg [p < 0.0001], 10.2 +/- 1.8 mg v 7.2 +/- 1.6 mg [p = 0.0003), and 40.2 +/- 4.5 mg v 34.8 +/- 6.3 mg [p = 0.02], respectively). CONCLUSION: Postoperative use of magnesium sulfate reduced opioid consumption for pain after thoracotomy operations.     

Magnesium sulfate decreases maternal blood pressure but not uterine blood flow during epidural anesthesia in gravid ewes

The purpose of this study was to determine whether administration of magnesium sulfate decreased maternal blood pressure during epidural anesthesia in gravid ewes. Twenty-two experiments were performed in 11 chronically instrumented animals between 0.8 and 0.9 of timed gestation. The experimental sequence included: 1) T = 0: magnesium sulfate 4 g intravenously over 5 min followed by an infusion of magnesium sulfate at 4 g/h, or normal saline iv followed by an infusion of normal saline alone; 2) T = 135 min: 500 ml normal saline intravenously over 12 min; and 3) T = 150 min: epidural administration of 2% lidocaine. The initial bolus of magnesium sulfate slightly decreased maternal mean arterial pressure (MAP) but increased uterine artery blood flow (UBF). The increase in UBF was accompanied by an increase in fetal PaO2 at 145 min in the magnesium sulfate group but not in the control group. At 165 min (i.e., 15 min after the epidural injection of lidocaine), epidural lidocaine resulted in a median sensory level of T-10 in the magnesium sulfate group and T-11 in the control group. During epidural anesthesia, maternal MAP was lower (P = 0.001) in the magnesium sulfate group than in the control group. At 165 min, maternal MAP was 18 +/- 3% below baseline (P = 0.0001) in the magnesium sulfate group but did not differ significantly from baseline in the control group. Maternal cardiac output and UBF did not differ from baseline after epidural injection of lidocaine in either group.(ABSTRACT TRUNCATED AT 250 WORDS)     

Magnesium Sulfate Does Not Reduce Postoperative Analgesic Requirements

Background: Because magnesium blocks the N-methyl-d-aspartate receptor and its associated ion channels, it can prevent central sensitization caused by peripheral nociceptive stimulation. However, transport of magnesium from blood to cerebrospinal fluid (CSF) across the blood-brain barrier is limited in normal humans. The current study was designed to evaluate whether perioperative intravenous magnesium sulfate infusion affects postoperative pain.

Methods: Sixty patients undergoing abdominal hysterectomy received 50 mg/kg intravenous magnesium sulfate as a bolus dose followed by a continuous infusion of 15 mg [middle dot] kg-1 [middle dot] h-1 for 6 h (magnesium group) or the same volume of isotonic saline (control group). At the end of surgery, serum and CSF magnesium concentration were measured in both groups. The cumulative postoperative analgesic consumption was measured to assess the analgesic effect using a patient-controlled epidural analgesia device. Pain intensities at rest and during forced expiration were evaluated at 6, 24, 48, and 72 h postoperatively.

Results: At the end of surgery, patients in the magnesium group had significantly greater postoperative serum magnesium concentrations compared with both preoperative and control group values (P < 0.001). Despite significantly higher serum magnesium concentrations in the magnesium group, there was no significant difference in magnesium concentration measured in postoperative CSF. Cumulative postoperative analgesic doses were similar in both groups. However, there was observed an inverse relation between cumulative postoperative analgesic consumption and the CSF magnesium concentration in both groups. Visual analog pain scores at rest and during forced expiration were similar and less than 4 in both groups.     

七氟烷全凭吸入麻醉用于小儿腭裂手术的临床观察

目的：观察七氟烷复合氧化亚氮全凭吸入麻醉用于小儿腭裂手术的临床效果。方法：选40例按美国麻醉医师学会（American Society of Anesthesiologiests,ASA）身体分级为I～II级的腭裂手术患儿,年龄1.5～4岁,随机分为两组。K组：给予氯胺酮5～8mg/kg＋丙泊酚1.5mg/kg＋维库溴铵0.1～0.15mg/kg诱导插管,术中丙泊酚5～10mg/（kg·h）麻醉维持。S组：给予七氟烷8%面罩吸入＋维库溴铵0.1～0.15mg/kg缓慢静注诱导,术中吸入七氟烷及氧化亚氮和氧气,氧化亚氮1L/min、氧气1L/min,七氟烷1.2～1.5MAC（3%～4%）维持麻醉。根据术中血流动力学状况和手术刺激程度,适当调控麻醉深度。采用SPSS11.0软件包进行统计。结果：两组诱导插管均顺利。K组诱导后患儿心率显著增快（P〈0.01）、血压下降（P〈0.05）,插管及术中剥离腭瓣时仍保持较快心率（P〈0.01）,与S组比较有显著差异（P〈0.01）。S组在诱导后患儿心率、血压有所下降（P〈0.05）,但插管和术中心率血压基本保持平稳。术后S组患儿自主睁眼和拔管的时间显著早于K组（P〈0.05）。结论：七氟烷复合氧化亚氮麻醉能较舒适、平稳地满足小儿腭裂手术要求。     

低位肛瘘术后中医辨证分期换药的疗效观察

为探讨低位肛瘘术后中医辨证分期换药的临床疗效,回顾接受手术治疗的113例低位肛瘘患者资料,其中55例患者术后根据不同时期采用大黄油纱、生肌玉红膏油纱换药（治疗组）,58例患者采用凡士林油纱换药（对照组）。对比两组患者术后第4、8、14、21天肛门疼痛及肉芽组织生长情况．以及创面愈合时间。结果显示,治疗组术后第4、8、14、21天肛门疼痛评分均日月娩低于对照组,P〈0．05;两组术后第4天肉芽组织生长情况评分差异无统计学意义,P〉0．05,但治疗组术后第8、14、21天肉芽组织生长情况评分均叫显高于对照组,P〈0．05;治疗组创面愈合时间明显短于对照组,P〈0．05。结果表明,根据低位肛瘘术后中医辨证分期采用大黄油纱、生肌玉红膏油纱换药可明显减轻患者肛门疼痛,缩短创面愈合时间,值得临床推广应用。