胰岛素湿敷在氯化钾外渗性皮肤损伤中的应用  

Application of dressing with topical insulin in healing of potassium chloride extravasation-induced skin injury

作　　者：沈艳秋 漆晓芹 冯玉玲[2] 郑静 陈思[1] 冯沙沙 谢兆勤 吴晶晶 丁亦含 张婷 刘惠 许佳 刘娟 赵迎春 Shen Yanqiu;Qi Xiaoqin;Feng Yuling;Zheng Jing;Chen Si;Feng Shasha;Xie Zhaoqin;Wu Jingjing;Ding Yihan;Zhang Ting;Liu Hui;Xu Jia;Liu Juan;Zhao Yingchun(Department of Hematology,Huai′an First People′s Hospital,Huai'an 223300,China)

机构地区：[1]淮安市第一人民医院血液科,江苏淮安223300 [2]江苏大学附属人民医院静脉输液治疗护理中心 [3]淮安市第五人民医院神经外科 [4]淮安市第五人民医院重症医学科

出　　处：《护理学杂志》2025年第6期35-37,50,共4页Journal of Nursing Science

基　　金：淮安市自然科学研究计划(HAB202205)。

摘　　要：目的 探究胰岛素稀释液用于高浓度氯化钾外渗性皮肤损伤的湿敷效果。方法 对23例静脉注射高浓度氯化钾外渗性皮肤损伤患者,采用胰岛素稀释液(胰岛素注射液20 U加入0.9%氯化钠注射液250 mL中)湿敷,观察湿敷效果。结果 第1例患者外渗局部发生坏死,胰岛素稀释液湿敷6 d,外渗性皮肤损伤愈合时间为10 d。其余22例湿敷时间3.00(2.00,4.00)d,愈合时间4.00(2.00,5.00)d。外渗后24 h内湿敷组与24 h后湿敷组比较、伴有糖尿病组与不伴有糖尿病组比较,外渗面积、疼痛评分及愈合时间差异无统计学意义(均P>0.05);氯化钾浓度2%组、4%组和6%组湿敷后第3天疼痛评分及愈合时间比较,差异有统计学意义(均P<0.05)。结论 高浓度氯化钾外渗性皮肤损伤患者采用胰岛素稀释液湿敷有效、安全。Objective To investigate the effectiveness of insulin dilutions for moist dressing in treating skin injury caused by extravasation of concentrated potassium chloride.Methods A total of 23 patients with extravasation injury following intravenous injection of concentrated potassium chloride were treated with a moist dressing using insulin dilution(20 U of insulin injection added to 250 mL of 0.9% sodium chloride injection).The effects of the dressing with topical insulin were observed.Results In the first case,necrosis occurred at the extravasation site.After 6 days of insulin therapy,the skin injury healed within 10 days.The remaining 22 patients had the moist dressing duration of 3.00(2.00,4.00) days and the healing time of 4.00(2.00,5.00) days.There were no statistically significant differences in the extravasation area,pain intensity,or healing time between patients who underwent moist dressing within 24 hours or after 24 hours of extravasation,and between patients with or without diabetes(all P>0.05).In the 2%,4%,and 6% potassium chloride concentration groups,pain intensity on the third day and healing time showed significant differences(all P<0.05).Conclusion Moist dressing with insulin dilutions is effective and safe for treating skin injury caused by extravasation of potassium chloride.

关 键 词：氯化钾 药物外渗 皮肤损伤 组织坏死 胰岛素 湿敷 糖尿病 疼痛 

分 类 号：R472[医药卫生—护理学]