CAJ | 학술논문

目的探讨自制10％氯化钠棉垫冰袋在局部软组织损伤患者中的临床应用效果.方法将下肢软组织损伤需要早期冷敷的患者62例分为对照组30例与观察组32例,对照组采用清水棉垫冰袋冷敷,观察组采用10％氯化钠棉垫冰袋冷敷,观察两种冰袋0,0.5,1.5,2h后内部的温度、冰袋与体表之间的温度、硬度、与体表的接触面大小及两组患者疼痛、肿胀程度及患者的满意度.结果 10％氯化钠棉垫冰袋内部初始温度(- 18.38±0.81)℃,冷敷期间冰袋与体表之间的温度为约18℃,冷敷30 min后测得冰袋内部的温度为(-9.73±0.54)℃.室温放置1h后,第2次冷敷时冰袋内部的温度为(-2.55±1.66)℃,第2次冷敷时测量冰袋与体表之间的温度约22℃,结束后冰袋内部的温度为(8.5±1.81)℃,第1,2次冷敷时硬度小,皮肤接触冰袋面积约72％,清水棉垫冰袋硬度大,早期温度计无法插入,不能准确的测量温度,皮肤接触冰袋面积达29％左右,两种方法0,0.5,1.5,2.0h时皮肤冰袋接触面积比较,差异有统计学意义(t分别为49.32,49.32,49.32,39.64；P＜0.05).两组患者冷敷前疼痛度比较,差异无统计学意义(x2 =0.017,P＞0.05),冷敷48 h后,观察组患者疼痛评级明显低于对照组,两组比较,差异有统计学意义(U=3.01,P＜0.05).冷敷48 h后两组患者肿胀评分比较,差异有统计学意义(U=2.58,P＜0.05).观察组患者的满意例数(31例)明显高于对照组(24例),两组比较,差异有统计学意义(x2 =4.4,P＜0.05).结论自制10％氯化钠棉垫冰袋,冰袋与体表之间的温度均高于皮肤冻结温度-5℃,不会造成冻伤,又低于基础体温,即达到目的,又不冻伤组织；接触面积大,容易固定、塑形,对于局部软组织损伤早期的肿胀及疼痛疗效较好,建议推广应用.
목적 탐토자제10％록화납면점빙대재국부연조직손상환자중적림상응용효과.방법 장하지연조직손상수요조기랭부적환자62례분위대조조30례여관찰조32례,대조조채용청수면점빙대랭부,관찰조채용10％록화납면점빙대랭부,관찰량충빙대0,0.5,1.5,2h후내부적온도、빙대여체표지간적온도、경도、여체표적접촉면대소급량조환자동통、종창정도급환자적만의도.결과 10％록화납면점빙대내부초시온도(- 18.38±0.81)℃,랭부기간빙대여체표지간적온도위약18℃,랭부30 min후측득빙대내부적온도위(-9.73±0.54)℃.실온방치1h후,제2차랭부시빙대내부적온도위(-2.55±1.66)℃,제2차랭부시측량빙대여체표지간적온도약22℃,결속후빙대내부적온도위(8.5±1.81)℃,제1,2차랭부시경도소,피부접촉빙대면적약72％,청수면점빙대경도대,조기온도계무법삽입,불능준학적측량온도,피부접촉빙대면적체29％좌우,량충방법0,0.5,1.5,2.0h시피부빙대접촉면적비교,차이유통계학의의(t분별위49.32,49.32,49.32,39.64；P＜0.05).량조환자랭부전동통도비교,차이무통계학의의(x2 =0.017,P＞0.05),랭부48 h후,관찰조환자동통평급명현저우대조조,량조비교,차이유통계학의의(U=3.01,P＜0.05).랭부48 h후량조환자종창평분비교,차이유통계학의의(U=2.58,P＜0.05).관찰조환자적만의례수(31례)명현고우대조조(24례),량조비교,차이유통계학의의(x2 =4.4,P＜0.05).결론 자제10％록화납면점빙대,빙대여체표지간적온도균고우피부동결온도-5℃,불회조성동상,우저우기출체온,즉체도목적,우불동상조직；접촉면적대,용역고정、소형,대우국부연조직손상조기적종창급동통료효교호,건의추엄응용.
Objective To explore the effect of self-made 10％ sodium chloride solution pad ice packs on the patients with local soft tissue injury in early time.Methods Totals of 62 cases with lower limb soft tissue injury were selected and randomly divided into experimental group ( n =32 ) that received the cold compress treatment by homemade 10％ sodium chloride solution pad ice packs,and control group( n =30) that received the cold compress treatment by water pad ice packs.Then,0,0.5,1.5,2 h later,the internal temperature,the temperature between the body surface and ice bag,hardness,the surface of contact surface size,and patients' satisfaction of two groups were observed.Results In the experimental group,the initial temperature of 10％sodium chloride solution pad ice packs was ( - 18.38 ±0.81 ) ℃,temperature between ice bag and body surface was 18℃ during cold compress,half an hour later,the temperature of inside ice bag was ( -9.73 ± 0.54)℃.After one hour in the room,the second cold compress,internal temperature was ( - 2.55 ± 1.66) ℃ and the temperature between ice bag and the surface was about 22 ℃,the end of ice internal temperature was (8.5 ±1.81 )℃.Hardness of first and secondary cold compress was small,the area size of skin contact with ice was about 72％.In the control goup,for the water cotton pad ice bags were so hardness that early thermometers were not inserted and temperature can not accurate measured.And the area of skin contact with ice was 29％.Significant differences were found in the contact area between two groups in different time (t =49.32,49.32,49.32,39.64,respectively; P ＜ 0.05 ).There was no significant difference in the pain degree of patients between two groups,while after 48 h cold compress,pain rating index and the swelling score of experimental group was significantly lower than that of control group(x2 =0.017,P ＜0.05).Patients' satisfaction of experimental group was significantly higher than that of control group ( x2 =4.4,P ＜ 0.05 ).Condusions Appling the selfmade 10％ sodium chloride solution pad ice packs,for the temperature between ice bag and the surface was higher than the skin freezing temperature( -5 ℃ ) and below the basal body temperature,which can reach the objective with no cause frostbite,it has large contact area,easy fixing and shaping,and good for patients with local soft tissue injury in early stage.