【摘要】 目的 比较上臂三角肌下缘及腹部脐周皮下注射药物的疼痛程度以及两种注射部位药物注射后局部不良反应。 方法 将2009年9月-2010年5月在我院门诊注射室执行皮下注射的患者200例。采用自身对照,分别在三角肌下缘与腹部脐周行皮下注射,根据视觉模拟评分法,对所有患者进行疼痛程度评估,将所得数据进行对比分析。 结果 腹部脐周皮下注射较上臂三角肌下缘注射疼痛评分低,差异有统计学意义(Z=6.02,Plt;0.005),两组注射局部均无不良反应。 结论 腹部脐周皮下注射疼痛程度较上臂三角肌下缘皮下注射疼痛程度轻。【Abstract】 Objective To compare the difference in pain degrees between subcutaneous injection at the lower edge of upper arm deltoid and at the abdominal peri-umbilicus, and to observe the adverse reactions of the two ways of injection. Methods A total of 200 patients who were in the outpatient injection room from September 2009 to May 2010 were injected subcutaneously at the lower edge of upper arm deltoid and the abdominal peri-umbilicus with the method of self control; the pain degrees were assessed by visual analog score and the data were analyzed. Results The pain scores between the two groups differed much (Z=6.02,Plt;0.005), while the difference in space distributions between the two groups was not significant. Conclusion The pain of subcutaneous injection at the abdominal peri-umbilicus is lighter than that at the lower edge of upper arm deltoid.
目的:评价低分子肝素(Low molecular weight heparins,LMWH)皮下注射持续时间对注射后皮下出血和疼痛的影响。方法:纳入2003年~2004年3月于我院行LMWH皮下注射的住院患者52例,以肚脐两侧作为注射点,任选一侧行首次注射,12 h后于另一侧以相同剂量注射。脐右注射持续10秒(对照组),脐左持续30秒(实验组)。于注射后48 h、72 h观察注射点有无皮下出血,并用透明纸质毫米尺测量出血面积,用视觉类比量表(Visual analog scale,VAS)测量疼痛强度,记录疼痛持续时间。采用卡方检验及配对t检验对两组皮下出血发生率及面积、疼痛强度及持续时间等指标进行对比分析。结果:实验组和对照组皮下出血的发生率分别为38.5%(n=20)和61.5%(n=32)(P=0.035)。注射后48h、72h,实验组的出血面积均显著低于对照组(48h:17.5±7.3 mm2 VS 101.2±15.0 mm2,P=0.008;72h:20.7±8.0 mm2 VS 110.4±13.5 mm2,P=0.016)。实验组的注射后疼痛积分为13.0±6.4 mm,对照组为21.5±7.0 mm(P=0.021)。实验组疼痛持续时间显著低于对照组(42.5±14.2 s比73.2±20.0 s,P=0.030)。结论:肝素皮下注射持续时间能显著影响注射后皮下出血和疼痛形成,注射时间持续至30秒能有效降低皮下出血发生率及面积,并显著减轻疼痛强度、缩短疼痛时间。