复方丹参注射液湿敷联合氦氖激光治疗新生儿输液所致静脉炎的疗效

1、复方丹参注射液湿敷联合氦氖激光治疗新生儿输液所致静脉炎的疗效及机制         09-05-18 17:08:00     编辑：studa20                    作者：黄婷李志辉黄丽红王影齐钟翠芳张家榕【摘要】 目的 观察复方丹参注射液湿敷联合氦氖激光治疗新生儿输

2、液所致静脉炎的临床疗效及机制。方法 采用随机分组的方法，将80例新生儿输液所致静脉炎患儿分为两组：复方丹参注射液湿敷联合氦氖激光治疗为治疗组 (n=40)、50%硫酸镁湿敷联合氦氖激光治疗为对照组(n=40)进行5 d的治疗，于治疗开始、第6天进行临床评估，同时检测血小板聚集率。结果 治疗前，新生儿输液所致静脉炎患儿血小板聚集率均明显高于正常组(P<0.01)；治疗5 d后，治疗组的患儿显效率、总有效率均明显高于对照组(P<0.01)，同时治疗组患儿血小板聚集率较对照组显著下降(P<0.05)，而对照组患儿治疗前后血小板聚集率无显著性差异(P>0.05)。结论 复方丹参

3、注射液湿敷联合氦氖激光治疗新生儿输液所致静脉炎效果优于50%硫酸镁湿敷联合氦氖激光治疗，值得在临床推广应用。复方丹参注射液能降低新生儿输液所致静脉炎患儿血小板聚集率，抑制效应可能是复方丹参注射液治疗新生儿输液所致静脉炎的重要机制。 【关键词】 复方丹参注射液；湿敷；氦氖激光；静脉炎；血小板聚集率；新生儿 【Abstract】 Objective To explore the mechanism and effect of compound salvia miltiorrhiza injection wet packing and helium neon(He-Ne) laser irradia

4、tion on treatment of neonatal phlebitis caused by transfusion. Methods 100 patients with neonatal phlebitis caused by transfusion were randomly divided into two groups, treatment group: compound salvia miltiorrhiza injection wet packing plus and helium neon(He-Ne) laser irradiation(40 cases) and con

5、trol group: 50% bitter salt wet packing plus He-Ne laser irradiation (40 cases).The duration of treatment was 5 days. 20 health newborn were served as normal control group. Before starting therapy, 6 days later, clinical effects were observed; the platelet aggregation ratio was measured. Results Bef

6、ore treatment, the platelet aggregation ratio in patients with neonatal phlebitis caused by transfusion were significantly higher than those in normal control group (P<0.01). After treatment, The efficiency and the total efficiency of 80% and 100% in treatment group; the efficiency and the total

7、efficiency of 15% and 80% in control group, there was significant difference between the two group (P<0.01). The platelet aggregation ratio decreased significantly in treatment group compared with those in control group (P<0.05). The platelet aggregation ratio in control group had no significa

8、ntly difference both pre-treatment and post-treatment(P>0.05).Conclusion The effect of neonatal phlebitis caused by transfusion treated by compound salvia miltiorrhiza injection and He-Ne laser was better than that of 50% bitter salt and He-Ne laser, its worth for popularization. Compound salvia

9、miltiorrhiza injection wet packing can lower the platelet aggregation ratio in serum of neonatal phlebitis caused by transfusion. The suppressive effects may be an important mechanism for compound salvia miltiorrhiza injection to antagonize neonatal phlebitis caused by transfusion. 【Key words】 Compo

10、und salvia miltiorrhiza injection; Wet packing; Helium neon laser;Phlebitis; Platelet aggregation ratio; Newborn 新生儿疾病治疗大多需要静脉输液治疗，静脉输液时间较长。但由于新生儿日龄小、体质差、机体抵抗力低、血管细及脆弱、通透性高，特别在输注静脉高营养液体如氨基酸、脂肪乳、白蛋白及脱水剂如甘露醇等高浓度药物时，极易发生输液所致静脉炎。深圳市罗湖区妇幼保健院自2003年4月至2008年6月用复方丹参注射液湿敷配合氦氖激光治疗新生儿输液所致静脉炎40例,并与用50%硫酸湿敷配合氦氖激光

11、治疗法进行对照，疗效显著且优于后者，现报告如下。 1 资料与方法 1.1 临床资料 收集2003年4月至2008年6月在本院新生儿科住院的危重新生儿中因输液所致静脉炎患儿80例，其中男58例，女22例；胎龄3741周；体质量25503850 g；日龄为417 d。80例患儿随机分为两组：治疗组、对照组，每组40例。两组间胎龄、体质量、日龄的差异无统计学意义（P>0.05）。另选择正常足月新生儿20例作为正常组。 1.2 治疗方法 治疗组：清洗患儿病变局部，将折叠厚度810层的纱布浸过复方丹参注射液，拧至恰不滴水，敷患处，范围超过炎症区域0.51 cm，每10 min更换一次敷布，连敷3遍

12、，2次/d。每次湿敷完后予氦氖激光照射病变局部，采用He-Ne激光治疗仪，输出功率为20 mW，照射距离为4060 cm，光斑直径1 cm，2次/d，每次10 min，5 d为1个疗程；对照组：清洗患儿病变局部，取50%硫酸镁倒于无菌纱布上(以不滴水为度) ，外敷于静脉炎处，范围超过炎症区域0.51 cm，每10 min更换一次敷布，连敷3遍，2次/d。每次湿敷完后予氦氖激光照射病变局部，采用He-Ne激光治疗仪，输出功率为20 mW，照射距离为4060 cm，光斑直径1 cm，2次/d，每次10 min，5 d为1个疗程。 1.3 诊断标准 静脉炎判断标准依据美国静脉输液护理学会所规定的指标

13、1。I度：局部红肿，压痛；无可见线条；无可触及静脉索条；发生范围在导管长度以内。度：局部压痛、热、红肿或水肿；有可见线条；无可触及静脉索条；发生范围在导管长度以内。度：局部疼痛、热、红肿甚至脓肿；有可见线条；有可触及静脉索条；发生范围在导管长度以外。 1.4 静脉炎疗效判断标准 疗效判断标准分为显效、有效、无效3种。显效：局部肿胀消失，压之不痛，静脉管壁硬度明显变软，弹性恢复，行静脉穿刺顺利；有效：局部肿胀消失，压之不痛，静脉管壁弹性基本恢复，可行静脉穿刺；无效：局部肿胀未消失，压之略痛，静脉管壁硬度改善和弹性恢复不明显2(总有效率=显效+有效)。 1.5 测定指标及方法 每例治疗前后测定血小板聚集率，采用比浊法测定。 1.6 统计学方法 数椐用均值±标准差(x±s)表示，采用SPSS10.