10％氯化钠棉垫冰袋在早期局部软组织损伤患者中的应用

目的探讨自制10％氯化钠棉垫冰袋在局部软组织损伤患者中的临床应用效果。方法将下肢软组织损伤需要早期冷敷的患者62例分为对照组30例与观察组32例，对照组采用清水棉垫冰袋冷敷，观察组采用10％氯化钠棉垫冰袋冷敷，观察两种冰袋0，0．5，1．5，2h后内部的温度、冰袋与体表之间的温度、硬度、与体表的接触面大小及两组患者疼痛、肿胀程度及患者的满意度。结果10％氯化钠棉垫冰袋内部初始温度（-18．38±0．81）℃，冷敷期间冰袋与体表之间的温度为约18℃，冷敷30min后测得冰袋内部的温度为（-9．73±0．54）℃。室温放置1h后，第2次冷敷时冰袋内部的温度为（-2．55士1．66）℃，第2次冷敷时测量冰袋与体表之间的温度约22℃，结束后冰袋内部的温度为（8．5±1．81）℃，第1，2次冷敷时硬度小，皮肤接触冰袋面积约72％，清水棉垫冰袋硬度大，早期温度计无法插入，不能准确的测量温度，皮肤接触冰袋面积达29％左右，两种方法0，0．5，1．5，2．0h时皮肤冰袋接触面积比较，差异有统计学意义（t分别为49．32，49．32，49．32，39．64；P〈0．05）。两组患者冷敷前疼痛度比较，差异无统计学意义（X2=0．017，P〉0．05），冷敷48h后，观察组患者疼痛评级明显低于对照组，两组比较，差异有统计学意义（U=3．01，P〈0．05）。冷敷48h后两组患者肿胀评分比较，差异有统计学意义（U=2．58，P〈0．05）。观察组患者的满意例数（31例）明显高于对照组（24例），两组比较，差异有统计学意义（X2=4．4，P〈0．05）。结论自制10％氯化钠棉垫冰袋，冰袋与体表之间的温度均高于皮肤冻结温度-5℃，不会造成冻伤，又低于基础体温，即达到目的，又不冻伤组织；接触面积大，容易固定、塑形，对于局部软组织损伤早期的肿胀及疼痛疗效较好，建议推广应用。

Application of the serf-made 10% sodium chloride solution pad ice packs in early local soft tissue injury patients

Objective To explore the effect of self-made 10Ve sodium chloride solution pad ice packs on the patients with local soft tissue injury in early time. Methods Totals of 62 eases with lower limb soft tissue injury were selected and randomly divided into experimental group （ n = 32） that received the cold compress treatment by homemade 10% sodium chloride solution pad ice packs, and control group （n = 30） that received the cold compress treatment by water pad ice packs. Then, 0,0.5,1.5, 2 h later, the internal temperature, the temperature between the body surface and ice bag, hardness, the surface of contact surface size, and patients＇ satisfaction of two groups were observed. Results In the experimental group, the initial temperature of 10% sodium chloride solution pad ice packs was （ - 18.38- 0.81 ） ℃, temperature between ice bag and body surface was 18℃ during cold compress, half an hour later, the temperature of inside ice bag was （ -9.73± 0.54）℃. After one hour in the room, the second cold compress, internal temperature was （ - 2.55 ± 1.66）℃and the temperature between ice bag and the surface was about 22 ℃, the end of ice internal temperature was （ 8.5 ±1.81 ）℃. Hardness of first and secondary cold compress was small, the area size of skin contact with ice was about 72%. In the control goup, for the water cotton pad ice bags were so hardness that early thermometers were not inserted and temperature can not accurate measured. And the area of skin contact with ice was 29%. Significant differences were found in the contact area between two groups in different time （t = 49.32,49.32, 49.32,39.64, respectively; P 〈 0. 05 ）. There was no significant difference in the pain degree of patients between two groups, while after 48 h cold compress, pain rating index and the swelling score of experimental group was significantly lower than that of control group （ X2 = 0.017, P 〈 0.05）. Patients＇ satisfaction of experimental group was significantly higher than that of control group （ X2 = 4.4, P 〈 0. 05 ）. Conclusions Appling the self- made 10% sodium chloride solution pad ice packs, for the temperature between ice bag and the surface was higher than the skin freezing temperature（ -5℃ ） and below the basal body temperature, which can reach the objective with no cause frostbite, it has large contact area, easy fixing and shaping, and good for patients with local soft tissue injury in early stage.