50％笑气／氧气吸入在烧伤儿童换药镇痛中的应用  

Application of inhaling 50 % nitrous oxide on burn pediatric patients during and after dressing change

作　　者：王海霞[1] 李玉香[3] 周茹珍 冯苹[1] 周万芳[1] 马静[1] 胡晓燕[1] 王光毅[1] 朱世辉[1] 唐洪泰[1] 夏照帆[1] 赵继军[2] 

机构地区：[1]第二军医大学附属长海医院烧伤科,上海200433 [2]第二军医大学附属长海医院护理部 [3]宁夏医科大学护理学院,银川750021

出　　处：《中华现代护理杂志》2015年第11期1267-1269,共3页Chinese Journal of Modern Nursing

基　　金：上海市卫生和计划生育委员会委级科研项目（20134019）

摘　　要：目的探讨50％笑气／氧气在烧伤儿童创面换药中及换药后的镇痛作用。方法选取2012年11月—2014年11月120例烧伤儿童，采用计算机随机法将患儿分为对照组（创面换药吸入氧气）30例，治疗组（创面换药中吸入50％笑气／氧气）90例，对照组患儿创面换药中吸入氧气，治疗组患儿创面换药中采用50％笑气／氧气镇痛系统镇痛，其余治疗相同。于换药前、换药中、换药后分别记录患儿的疼痛评分、心率、收缩压、舒张压及血氧饱和度，观察有无不良反应。对数据进行卡方检验、t检验及协方差分析。结果换药前两组患儿心率、收缩压、舒张压及血氧饱和度比较差异无统计学意义（t值分别为0．34，0．57，0．11，0．98；P〉0．05）。与对照组比较，治疗组患儿换药中心率、收缩压、舒张压及血氧饱和度改善（￡值分别为25．96，24．11，8．37，20．29；P〈0．01）。两组患儿换药后舒张压无统计学意义（t=1．57，P〉0．05），心率、收缩压及血氧饱和度的组间比较差异均有统计学意义（t值分别为5．20，8．64，3．37；P〈0．01）。换药前两组患儿疼痛评分差异无统计学意义（t=0．18，P〉0．05）。与对照组比较，治疗组患儿换药中及换药后的疼痛评分（2．82±0．80），（1．20±0．84）降低，（t值分别为23．00，4．30；P〈0．01），两组患儿换药中疼痛评分的协方差分析结果示差异有统计学意义（F=867．956，P〈0．01）。两组患儿在换药中、换药后均未发生明显不良反应。结论50％笑气／氧气吸入在烧伤儿童创面换药中具有明显的镇痛作用，可用于日常烧伤儿童创面换药镇痛。Objective To investigate the analgesic effects of inhaling 50% nitrous oxide on burn pediatric patients during and after dressing change. Methods A total of 120 burn pediatric patients received outpatient dressing and hospitalized from September 2012 to September 2014 were enrolled in our study, and they were all in accordance with the inclusion criteria. The 120 pediatric patients were divided into control group （ n = 30） treated with inhalation of oxygen during dressing change） and treatment group （ n = 90 ） treated with inhalation of 50% nitrous oxide during dressing change） according to the computer-generated list of random number. The other treatments in control group and treatment group were the same. Before, during and after dressing change, degree of pain, heart rate, systolic blood pressure, diastolic blood pressure, oxygen saturation and adverse effects were observed at the same time points. Data were processed with analysis of chi-square test, covariance and Student＇s t test. Results There were no significant differences between the two groups in levels of HR, SBP, DBP, and SpO2 before dressing change （t = 0.34, 0.57, 0.11, 0.98, respectively ;P 〉 0.05 ）. Compared with those of control group, levels of HR, SBP, DBP, and SpO2 in treatment group were significantly ameliorated during dressing change （t = 25.96, 24.11, 8.37, 20.29, respectively ; P 〈0. 01 ）. After dressing change, the levels of DBP in the two groups were close （t = 1.57 ,P 〉0.05）, but the levels of HR, SBP, and SpO2 showed statistical differences （t =5.20, 8.64, 3.37, respectively;P 〈0.01 ）. Before dressing change, the pain scores were approximate between control group and treatment group （ t = 0.18, P 〉 0.05 ）. Compared with those in control group, the pain scores in treatment group during and after dressing change were （2.82 ± 0.8） and （ 1.2 ± 0.84）, which were significantly lower than those in the control group （ t = 23.00, 4.30,respectively; P 〈0.01 ）. There were no obvious ad

关 键 词：烧伤 儿童 镇痛 50%笑气/氧气 换药 

分 类 号：R473.72[医药卫生—护理学]