生理盐水在儿童骨牵引针道护理中的应用研究

目的探讨生理盐水在儿童骨牵引针道护理应用的可行性。方法将2017年1月至2018年12月华中科技大学同济医学院附属武汉儿童医院小儿骨科收治的208例骨牵引患儿,根据入院时间段分为对照组(113例)和观察组(95例)。对照组使用75%乙醇对骨牵引针道进行常规护理(2次/d),观察组按需使用生理盐水对骨牵引针道进行护理。采用中文版儿童疼痛行为量表(FLACC)评估患儿针道护理时的疼痛情况,Checketts Otterburns感染分级系统评估患儿针道感染情况。结果针道护理时,观察组的FLACC评分为(1.58±0.71)分,优于对照组的(2.06±0.86)分,差异有统计学意义(t=4.280,P<0.001)。观察组发生针道Ⅰ度感染2例,感染发生率为2.11%(2/95);对照组发生针道Ⅰ度感染4例,Ⅲ度感染1例,感染发生率为4.42%(5/113);两组针道感染发生率比较,差异无统计学意义(Z=-1.15,P=0.248)。结论儿童骨牵引针道采用生理盐水按需护理,可预防针道感染发生,减轻针道护理时的疼痛刺激,提高患儿舒适度。

Application of normal saline for pin site care in children with skeletal traction

Objective To investigate the feasibility of using normal saline for pin site care in children with skeletal traction.Methods From January 2017 to December 2018,208 bone traction children treated in Pediatric Orthopaedics of Wuhan Children's Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology were divided into control group(113 cases)and observation group(95 cases)according to admission time.The control group was treated with 75% ethanol for pin site care(twice a day),and the observation group was treated with normal saline on demand.The Chinese version of the Pain Behavior Scale(FLACC)was used to assess the pain of the children during pin site care of the skeletal traction.The Checketts Otterburns infection grading system was used to assess the degree of skeletal infection.Results The FLACC score in the observation group during pin site was 1.58±0.71,which was significantly lower than that in the control group(2.06±0.86,t=4.280,P<0.001).In the observation group,there were 2 cases of gradeⅠinfection,and the infection rate was 2.11%(2/95);in the control group,there were 4 cases of gradeⅠinfection and 1 case of gradeⅢinfection,and the infection rate was 4.42%(5/113);there was no significant difference in the infection rate between the two groups(Z=-1.15,P=0.248).Conclusion Using normal saline on demand for pin site care in children with skeletal traction can prevent the occurrence of pin site infection,reduce the painful stimulation during pin site care,and improve the comfort of children.