复方利多卡因乳膏在减轻血液透析内瘘穿刺疼痛中的效果观察  

Observation on the effect of compound lidocaine cream in reducing the pain of hemodialysis and fistula puncture

作　　者：王勤[1] 张帆[1] 吕星 Wang Qin;Zhang Fan;Lv Xing(Leshan City People 's Hospital Nephrology Internal Medicine Blood Purification Center,Leshan,614000,China)

机构地区：[1]四川省乐山市人民医院肾病内科血液净化中心,乐山614000

出　　处：《当代护士（下旬刊）》2018年第12期130-133,共4页Modern Nurse

摘　　要：目的探讨复方利多卡因乳膏对减轻血液透析动静脉内瘘患者穿刺疼痛的临床效果。方法选取血液透析中心108例首次动静脉内瘘穿刺维持性血液透析患者,按照随机数表法分为对照组和观察组各54例,对照组常规消毒后穿刺,观察组于穿刺前1 h用复方利多卡因乳膏涂抹后再消毒穿刺。用数字评分法(NRS)评估两组穿刺时的疼痛程度、记录穿刺前后收缩压(SBP)、心率(HR)的变化;用状态焦虑量表(SAI)、特质焦虑量表(TAI)、维持性血液透析患者舒适量表(GCQ)分别评估两组内瘘穿刺的心理状态。结果观察组穿刺的疼痛评分、状态-特质焦虑评分明显低于对照组,整体舒适度评分则高于对照组,差异有统计学意义(P<0.05);观察组穿刺前后平均收缩压和心率比较无明显变化,差异无统计学意义(P>0.05),对照组穿刺后的平均收缩压和心率均较穿刺前显著升高,差异有统计学意义(P<0.05)。结论采用复方利多卡因乳膏可明显减轻血液透析动静脉内瘘患者穿刺时的疼痛,稳定其血压和心率,减轻其疼痛带来的焦虑情绪,提高其透析舒适性、依从性及生活质量,值得临床推广应用。Objective To observe the clinical effect of compound lidocaine cream in reducing the pain of puncture pain in hemodialysis patients with arteriovenous fistula.Methods 108 patients with primary venous fistula maintenance hemodialysis were randomly divided into control group and observation group (54 cases).The patients in the control group were treated with routine disinfection and puncture.The patients in the observation group were treated with 1 Hour with a compound lidocaine cream after cleansing and then disinfection puncture.(SBP)and heart rate (HR) were measured before and after puncture.The patients were sacrificed by the state anxiety scale (SAI),trait anxiety scale (TAI) The maintenance hemodialysis patient comfort scale (GCQ)evaluated the psychological status of fistula puncture in both groups.Results The scores of pain and state-trait anxiety were significantly lower in the observation group than in the control group ,the overall comfort score was higher than the control group,the difference was statistically significant (P<0.05).There was no significant difference between the two groups (P>0.05).The mean systolic blood pressure and heart rate,the difference was statistically significant (P<0.05).Conclusion The use of compound lidocaine cream can significantly reduce the pain of hemodialysis arteriovenous fistula puncture,stabilize its blood pressure and heart rate,reduce the anxiety caused by pain,improve its dialysis comfort,compliance and quality of life ,Worthy of clinical application.

关 键 词：复方利多卡因乳膏 血液透析 内瘘穿刺疼痛 焦虑情绪 舒适度 

分 类 号：R459.5[医药卫生—治疗学]