利多卡因地塞米松联合山莨菪碱治疗甘露醇外渗临床应用.docVIP

利多卡因地塞米松联合山莨菪碱治疗甘露醇外渗临床应用 　　【摘要】 目的 探讨利多卡因、地塞米松联合山莨菪碱对甘露醇外渗的治疗作用。方法 将100例因甘露醇输液外渗的患儿随机分成观察组50例和对照组50例，观察组采用2%利多卡因、地塞米松加山莨菪碱混合液局部湿敷，对照组采用50%硫酸镁局部湿敷，比较两组疗效。结果 观察组与对照组的治疗总有效率分别是100%和70%，两组比较差异有统计学意义（P＜0.01）。结论 利多卡因、地塞米松加山莨菪碱对甘露醇输液外渗疗效确切，是安全可靠的治疗方法，值得临床推广应用。 　　【关键词】 利多卡因；地塞米松；山莨菪碱；甘露醇；药物外渗 　　Clinical application of Lidocaine and Dexamethasone and aAnisodamine in the treatment of Mannitol extravasationLI Shang-di,ZHOU Yue-qiong,ZENG Fei-yan.Department ofPediatrics,The Affiliated Hospital of Guangdong Medical College,Zhangjiang524001,China 　　【Abstract】 Objective To explore the therapeutic effect of Lidocaine and Dexamethasone and Anisodamine in the treatment of Mannitol extravasation. Methods 100 cases patients caused by Mannitol infusion extravasation wererandomly divided into 2 groups,each for 50 cases. Wet compress with Lidocaine and Dexamethasone and Anisodamine were used in the observation group and 50% Magnesium Sulfate was used in the control group. The effect of two groups were compared. Results The effective rate of the observation and control groups were 100% and 70%respectively, and there were significant differences between the two groups（P＜0.01）.Conclusion The effect of therapy of wet compress withLidocaine and Dexamethasone and Anisodamine to treat on infusion extravasation caused by Mannitol is obvious.It is a security and effective methodin the treatment of Mannitol extravasation.It is worthy of clinic application. 　　【Key words】 Lidocaine； Dexamethasone； Anisodamine； Mannitol； Drug extravasation 　　20%甘露醇在儿科临床上广泛应用于脱水降低颅内压、消除脑水肿。由于甘露醇为高渗脱水剂，快速静脉滴注时浓度较高，可造成血管壁细胞脱水、变性、影响细胞功能，引起局部疼痛。由于小儿在输液时不配合、哭闹、躁动，在输液过程中经常会发生液体外渗入皮下组织引起局部肿胀疼痛，严重时导致局部组织坏死，从而影响疾病的治疗，增加患儿的痛苦。为了减轻患儿的痛苦并提高护理质量，我科自2009年1月始对静脉滴注甘露醇外渗的患儿应用利多卡因、山莨菪碱、地塞米松混合液局部外敷输液肿胀处，取得较好的效果，现报告如下。 　　1 资料与方法 　　1.1 一般资料 选取2009年1月至2010年7月收入院接受20%甘露醇治疗时发生输液外渗的患儿100例，其中男66例，女34例，年龄5个月～13岁，均为病毒性脑炎。将100例患儿随机分为观察组和对照组各50例，2组患儿在性别、年龄、病情、输液速度、血管情况等方面差异无统计学意义（P＞0.05），具有可比性。 　　1.2 方法 发生甘露醇输液外渗后，立即停止输液，拔针后按压穿刺点至无出血。观察组