肌内注射维生素K3导致局部疼痛的原因分析及处理对策

[目的]探讨肌内注射维生素K3导致局部疼痛的原因,并提出相应的处理对策。[方法]将60例注射维生素K3导致局部疼痛的患儿分为观察组和对照组,每组30例,观察组常规注射法出现疼痛后采用50%硫酸镁湿热敷及红外线烤灯照射,连续3 d,每天2次;对照组常规注射法出现疼痛后采用观察局部情况,下次注射时更换部位,比较两组患儿疼痛减轻的疗效。[结果]观察组患儿疼痛减轻率为96.7%,对照组为20.0%,差异有统计学意义(P<0.01)。[结论]采取50%硫酸镁湿热敷及红外线烤灯照射减少注射维生素K3导致局部疼痛的效果优于常规法。     

10%红花酒精湿敷减轻静脉补钾致局部疼痛的疗效观察

[目的]探讨10%红花酒精湿敷减轻静脉补钾致局部疼痛的疗效。[方法]选择静脉补钾致注射部位疼痛病人120例,随机分为观察组和对照组各60例,观察组用10%红花酒精湿敷,对照组用50%硫酸镁湿热敷,输液完毕观察两组病人疼痛程度。[结果]观察组疗效显著优于对照组(P<0.05)。[结论]10%红花酒精湿敷能有效减轻静脉补钾所致注射部位疼痛。     

神灯联合硫酸镁治疗静脉输液外渗的效果观察

[目的]观察神灯联合硫酸镁治疗静脉输液外渗的效果。[方法]将80例静脉输液外渗的病人随机分为观察组和对照组各40例,观察组用神灯照射加硫酸镁湿热敷治疗,对照组单用50%硫酸镁溶液湿热敷,观察两组病人的治疗效果。[结果]观察组总有效率高于对照组(P<0.05)。[结论]神灯照射联合硫酸镁湿热敷治疗静脉输液外渗效果优于单用50%硫酸镁溶液湿热敷。     

红外线照射缓解静脉输注甘露醇引起局部疼痛的疗效观察

[目的]探讨红外线照射对缓解静脉输注甘露醇引起注射部位疼痛的镇痛效果。[方法]选择100例腰椎间盘突出症急性发作需静脉输注甘露醇的门诊病人,随机分为两组,红外线组50例和对照组50例。在静脉输注20%甘露醇5min后对注射部位红外线组进行红外线照射,对照组则给予热水袋热敷至甘露醇输注完毕。采用痛视觉模拟评分法(VAS)评估两种方法的镇痛效果。[结果]红外线组镇痛有效率为98%,对照组有效率为18%,两组有效率比较有统计学意义(P<0.01);红外线组照射前后注射上肢疼痛VAS评分从7.9分±1.3分下降到1.7分±0.8分,对照组热敷前后注射上肢疼痛VAS评分从7.7分±1.6分下降到4.2分±0.9分,两组比较有统计学意义(P<0.01)。[结论]红外线照射对缓解静脉输注甘露醇引起的注射上肢疼痛有明显的疗效,优于热水袋热敷。     

中药湿热敷联合红外线理疗治疗类风湿性关节炎的疗效观察

[目的]观察中药湿热敷联合红外线理疗治疗类风湿性关节炎的临床疗效。[方法]将180例类风湿性关节炎病人按就诊先后顺序分为对照组与治疗组,每组90例。对照组给予常规治疗及护理,治疗组在常规治疗护理基础上加用中药湿热敷联合红外线理疗,比较两组病人治疗前后关节症状、体征改善情况。[结果]治疗组临床治疗总有效率(91.11%)高于对照组(66.67%)。[结论]中药湿热敷联合红外线理疗治疗类风湿性关节炎并加强护理干预,可显著减轻病人疼痛,提高疗效。     

硫酸镁湿热敷联合氦氖激光照射治疗PICC静脉炎效果观察

目的观察硫酸镁湿热敷联合氦氖激光照射治疗PICC静脉炎的效果。方法将56例PICC静脉炎患者按入院时间先后分为常规组和实验组。常规组采用50%硫酸镁湿热敷,实验组采用50%硫酸镁湿热敷联合氦氖激光照射治疗。结果实验组治疗PICC静脉炎效果明显优于对照组(P0.05)。结论用50%硫酸镁湿热敷联合氦氖激光照射治疗PICC静脉炎效果较好。     

新型敷料加清得佳凝胶治疗静脉炎的疗效观察

[目的]观察新型敷料加清得佳凝胶治疗静脉炎的疗效。[方法]将120例输液治疗后静脉炎的病人随机分为观察组和对照组,观察组使用清得佳凝胶加薄型泡沫敷料局部外敷,对照组给予50%硫酸镁湿热敷,治疗后随时观察疗效。[结果]观察组总有效率高于对照组(P <0.05),疼痛减轻时间与治愈时间短于对照组(P <0.01)。[结论]薄型泡沫敷料加清得佳凝胶治疗静脉炎的效果优于硫酸镁外敷。     

水胶体敷料联合红外线照射治疗静脉炎的疗效观察

[目的]探讨超薄型无菌水胶体敷料外贴联合红外线照射治疗化疗性静脉炎的效果.[方法]将60例化疗性静脉炎病人随机分为两组, 观察组30例使用超薄型无菌水胶体敷料外贴静脉炎部位联合红外线照射治疗,对照组30例采用50%硫酸镁湿热敷静脉炎部位,观察其疗效及治疗时间.[结果]观察组显效率明显高于对照组,差异有统计学意义(P<0.05);观察组治疗时间短于对照组,差异有统计学意义(P<0.01).[结论]超薄型无菌水胶体敷料外贴联合红外线照射治疗化疗性静脉炎疗效显著.     

喜辽妥治疗住院患儿输液外渗的效果观察

[目的]观察喜辽妥治疗住院患儿输液外渗的效果。[方法]将80例静脉输液外渗的患儿随机分为两组,实验组使用喜辽妥软膏外涂,对照组使用50%硫酸镁湿热敷。[结果]实验组治疗效果明显优于对照组。[结论]住院患儿静脉输液外渗后及时使用喜辽妥软膏外涂可有效减轻和避免局部炎症反应,且安全、简便、省时、高效,患儿也舒适。     

小儿阴囊急症应用硫酸镁湿敷联合红外线照射干预的效果观察

[目的]探讨硫酸镁湿敷联合红外线照射护理对小儿阴囊急诊预后的影响。[方法]选取在我院住院的小儿阴囊急诊病人54例,随机分为对照组和观察组各27例,对照组给予常规护理,观察组在常规护理的基础上给予硫酸镁局部湿敷联合红外线照射,观察两组伤口愈合时间、住院时间及术后并发症的发生情况。[结果]观察组患儿伤口愈合时间及住院时间较对照组短,术后并发症发生率较对照组低,差异有统计学意义(P0.05)。[结论]硫酸镁湿敷联合红外线照射可有效缩短病人的伤口愈合时间及住院时间,降低并发症的发生率。     

音乐干预对门诊肌内注射患儿心理状态和治疗配合度的影响

目的:探讨音乐干预对门诊肌内注射患儿心理状态和治疗配合度的影响。方法:将130例门诊肌内注射患儿按照随机数字表法分为观察组和对照组各65例,观察组注射时给予音乐干预,对照组注射时无任何背景音乐;比较两组干预后疼痛情况[采用Wong-Baker面部表情量表],比较两组干预前后心理状态[采用儿童焦虑性情绪障碍筛查表(SCARED)和儿童抑郁障碍自评量表(DSRSC)],比较两组哭闹时间及治疗配合度。结果:观察组Wong-Baker量表评分低于对照组(P<0.05),哭闹时间短于对照组(P<0.05);干预后,两组SCARED、DSRSC评分均低于干预前(P<0.05),且观察组低于对照组(P<0.05);观察组治疗配合度高于对照组(P<0.05)。结论:音乐干预能减轻门诊肌内注射患儿疼痛感,缩短哭闹时间,缓解不良情绪,提高患儿治疗配合度。     

改良抽吸药液操作技术在肌内注射苄星青霉素中的应用

目的探讨改良抽吸药液操作技术在肌内注射苄星青霉素中的应用及效果。方法将62例（246人次）肌内注射苄星青霉素的患者随机分为对照组30例（119人次）和观察组32例（127人次），对照组采用常规抽吸药液方法进行肌内注射。观察组采用改良式抽吸药液方法进行肌内注射。观察两组患者一次注射成功率及注射过程中疼痛程度。结果对照组10．9％感到重度疼痛，观察组为1．6％，两组比较差异有统计学意义（x^2=43．71，P〈0．01）。观察组一次注射成功率为98．4％高于对照组的89．1％，两组比较差异有统计学意义（x^2=45．09，P〈0．01）。结论采用改良式抽吸药液操作技术能提高肌内注射苄星青霉素一次成功率，减轻了患者的痛苦，值得II缶床推广使用。     

舒康博敷贴缓解老年患者肌内注射部位硬结的效果

目的 探讨舒康博敷贴缓解注射部位硬结的疗效.方法 对40例患者肌内注射硬结进行处理,随机分为实验组和对照组各20例,实验组采用舒康博敷贴外敷,对照组采用50%硫酸镁湿热敷,比较两组疗效.结果 两组在有效率和患者满意率上差异均有统计学意义（P＜0.05或P＜0.01）.结论 舒康博敷贴对老年患者注射部位硬结疗效明显,满意率高,是舒康博敷贴在临床应用上的新发现.     

两种不同注射方法对降低肌内注射患者疼痛程度的效果观察

目的 探讨采用两种不同注射方法对降低肌内注射患者疼痛程度的效果.方法 将200例行肌内注射治疗的患者分为试验组120例采用旋转法注射,对照组80例采用传统法注射.比较两组患者的痛觉程度.结果 试验组患者的痛觉程度低于对照组,两组比较,Z=2.181,P＜0.05,差异具有统计学意义.结论 采用旋转法肌内注射较传统的注射方法能有效减轻患者的疼痛.     

Topical amethocaine gel 4% for intramuscular injection in term neonates: a double-blind, placebo-controlled, randomized trial

Background: Topical local anesthetic agents such as amethocaine penetrate intact skin and block pain signals originating from the dermis during medical procedures. They have been found to attenuate pain from various procedures, including intramuscular (IM) injection of vaccines. Published data on their effectiveness for IM injection of vitamin K in neonates were not identified. Objectives: The primary objective of this study was to evaluate the analgesic effectiveness and tolerability of topical amethocaine gel 4% in neonates undergoing IM injection of vitamin K. The secondary objective was nurses' response to the use of the intervention and possible barriers associated with its incorporation into clinical practice. Methods: In a double-blind, placebo-controlled, randomized trial, full-term neonates in the Labor and Delivery Unit of Mount Sinai Hospital, Toronto, Ontario, Canada, received 1 g of amethocaine gel 4% or placebo 30 minutes prior to IM injection of 0.5 mL of vitamin K. Pain responses were assessed using percent facial grimacing score, percent cry duration, and latency to cry from video recordings. Parents and nurses assessed infants' pain response using a visual analog scale (VAS). Local adverse events (ie, erythema, blanching) at the application site were recorded. Nurses were asked to provide written responses regarding their willingness to incorporate local anesthetics in clinical practice and barriers to their use. Results: From July 2003 to December 2004, 175 families were approached for participation in the study; 52 declined consent and 13 were not randomized. One hundred ten neonates were enrolled and evenly randomized to each group. Baseline characteristics were similar in both groups. During IM injection, the mean (SD) percent facial grimacing score was 70% (30%) for the amethocaine group compared with 75% (34%) for the placebo group (P = 0.41). The mean (SD) for percent cry duration was 55% (34%) compared with 62% (38%), respectively (P = 0.34). The mean (SD) latency to cry was significantly longer in the amethocaine group compared with the placebo group (4.7 [4.5] vs 2.7 [2.3] seconds; P = 0.01). Parents' and nurses' VAS ratings for infant pain did not differ between groups. The incidence of adverse events did not differ between groups. Ninety-seven percent of nurses (89/92) said they would use the intervention. Fifty-seven percent of nurses (52/92) identified barriers to incorporation with the primary reason being time constraint (67% [35/52]). Conclusions: Topical amethocaine gel 4% was ineffective in reducing pain on IM injection of vitamin K in these full-term neonates. Treatment was generally well tolerated and nurses concluded that, given the choice, they would use a topical anesthetic.     

无痛点联合定位法在臀部肌内注射中的应用效果

目的探讨肌内注射中臀中肌三角定位和臀大肌连线法联合定位确定无痛点进行无痛注射的效果观察。方法将1200例门诊肌内注射患者随机分为实验组和对照组各600例,对照组进行传统的肌内注射方法,实验组采用联合定位无痛点的方法进行肌内注射,比较两组注射时疼痛程度。结果实验组疼痛程度低于对照组,差异有统计学意义（P〈0．01）。结论无痛点联合定位法降低了患者在肌内注射时的疼痛感,操作方法简便,具有较好的推广应用价值。     

痰热清联合α-2b干扰素治疗小儿手足口病的临床研究

目的探讨痰热清联合α-2b干扰素治疗小儿手足口病（HFMD）的疗效。方法将60例HFMD患儿按随机数字表法分为观察组和对照组,每组30例。2组均给予对症支持治疗,包括辅以Vit C、Vit B6以及补充电解质等,观察组同时给予痰热清注射液0.3-0.5 m L·kg^-1·d^-1,加入5%葡萄糖注射液100-250 m L中静脉滴注,1次·d^-1;重组人干扰素α-2b注射液3-10万U·kg^-1·d^-1,皮下注射或肌内注射;对照组给予利巴韦林注射液10-15 mg·kg^-1·d^-1,加入5%葡萄糖注射液100-250 m L中静脉滴注,1次·d^-1。2组均3 d为1个疗程。对2组患儿的临床疗效及不良反应进行比较。结果疗程结束后,观察组患者总有效率为100.00%,对照组总有效率为86.67%,2组比较差异有统计学意义（P〈0.05）。观察组患儿退热、退疹、进食、溃疡愈合及住院时间均明显短于对照组（均P〈0.05）。2组均未发生肝肾功能损害及其他严重不良反应。结论痰热清联合α-2b干扰素治疗小儿HFMD能明显提高临床治疗效果,且安全、可靠。     

Using Buzzy,Shotblocker, and Bubble Blowing in a Pediatric Emergency Department to Reduce the Pain and Fear Caused by Intramuscular Injection: A Randomized Controlled Trial

IntroductionProcedural pain in general, and intramuscular (IM) injection pain in particular, is one of the most distressing and painful health care experiences for children. Pharmacologic and nonpharmacologic methods are used as forms of pain control for children undergoing acute painful interventions in emergency departments.MethodsThis study was a prospective, randomized controlled trial. The sample consisted of children aged 5 to 10 years old who required IM injections. Children were placed in 4 subgroups through randomization, using a computer program: the Buzzy (MMJ Labs. Atlanta, GA) group (n = 40), the ShotBlocker (Bionix Development Corporation, Toledo, OH) group (n = 40), the bubble-blowing group (n = 40), and the control group (n = 40). Immediately before and after the injection, the children, their parents, and an observer were asked to evaluate the child’s level of fear. The Oucher scale was also employed by the observers, children, and parents immediately after the procedure to assess the level of pain in the children in each group.ResultsNo statistically significant difference was determined between the control and intervention groups in terms gender, age, previous pain experienced with injection, the parent who was with the child, the parent’s age. A significant difference was found between the intervention and control groups in terms of levels of pain and fear during IM injection. Pain and fear were notably less in the group of children receiving the Buzzy intervention.DiscussionThe Buzzy intervention should be used when children are undergoing IM injections to reduce their levels of pain and fear.     

康复治疗联合A型肉毒毒素局部注射治疗痉挛型脑性瘫痪的疗效

目的观察康复治疗联合A型肉毒毒索（BTX-A）局部注射治疗痉挛型脑性瘫痪的疗效。方法60例脑性瘫痪患儿随机分为治疗组和对照组各30例。治疗组采用康复治疗联合BTX-A局部注射；对照组采用单纯康复治疗。治疗12周后比较两组患儿的关节屈曲度、步态等临床指标。结果治疗组患儿各项临床评价指标的改善优于对照组（P〈0．05）。结论康复治疗联合BTX—A局部注射可提高脑性瘫痪的疗效。