注射用糜蛋白酶在尿道成形术后患儿伤口换药中的应用  

Application of Chymotrypsin for Injection in Wound Dressing Change after Urethroplasty in Children

作　　者：李玲芳[1] 唐静[1] 兰平[2] 康杰 朱玮安 万淑 刘琛[1] 万隆 LI Ling-fang;TANG Jing;LAN Ping;KANG Jie;ZHU Wei-an;WAN Shu;LIU Chen;WAN Long(Departmentof Urology,Jiangxi Provincial Children’s Hospital,Nanchang 330006,China;Departmentof Plastic Surgery,Jiangxi Provincial Children’s Hospital,Nanchang 330006,China)

机构地区：[1]江西省儿童医院泌尿外科,南昌330006 [2]江西省儿童医院整形美容科,南昌330006

出　　处：《实用临床医学（江西）》2023年第1期80-82,130,共4页Practical Clinical Medicine

基　　金：江西省卫健委科技计划(202130904)。

摘　　要：目的探讨注射用糜蛋白酶在尿道成形术后患儿伤口换药中的应用效果。方法选取2020年6月至2022年3月于江西省儿童医院泌尿外科接受尿道成形手术的88例尿道下裂患儿,将其随机分为试验组和对照组,各44例。试验组和对照组伤口换药前分别用16 mL的注射用糜蛋白酶稀释液(稀释于生理盐水中)和生理盐水浸润阴茎包扎敷料,敷料完全软化后予以换药。比较2组敷料完全软化所需时间、敷料与伤口粘连发生率、伤口出血发生率及换药时的疼痛程度[根据患儿年龄采用儿童疼痛行为量表(FLACC)、Wong-Baker面部表情疼痛评定量表(FPS)或视觉模拟量表(VAS)进行评估]。结果试验组患儿敷料完全软化时间较对照组明显缩短(P=0.006),且敷料与伤口粘连发生率、伤口出血发生率及换药时疼痛评分均低于对照组(均P<0.05)。结论注射用糜蛋白酶应用于尿道成形术后患儿伤口换药可加速血块溶解,加快敷料软化,缩短敷料浸润时间,减少敷料与伤口粘连及伤口出血的发生率,减轻疼痛。Objective To investigate the application of chymotrypsin for injection in wound dressing change after urethroplasty in children.Methods A total of 88 children with hypospadias who received urethroplasty in the department of urology of Jiangxi Children’s Hospital from June 2020 to March 2022 were randomly divided into two groups,with 44 patients in each group.The dressing for surgical wound of the penis was soaked with 16 mL chymotrypsin(diluted in normal saline)and normal saline in the experimental group and the control group,respectively.Dressing change was performed after the dressing was completely softened.The time of complete dressing softening,incidence of wound dressing adhesion and incidence of wound bleeding were compared between the two groups.In addition,the degree of pain during dressing change was assessed using the Face,Legs,Activity,Cry and Consolability(FLACC)scale,Wong-Baker Faces Pain Scale(FPS),and Visual Analog Scale(VAS).Results The time of complete dressing softening in the experimental group was shorter than that in the control group(P=0.006).The incidence of wound dressing adhesion and bleeding and the scores of pain during dressing change in the experimental group were lower than those in the control group(P<0.05).Conclusion The application of chymotrypsin for injection in wound dressing change after urethroplasty can accelerate clot dissolution and dressing softening,shorten dressing infiltration time,reduce the incidence of wound dressing adhesion and bleeding,and relieve pain in children.

关 键 词：尿道下裂 注射用糜蛋白酶 尿道成形术 伤口换药 

分 类 号：R473.72[医药卫生—护理学]