Abstract:

Objective　To explore the clinical nursing method of intramuscular injection with adrenocorticotropic hormone (ACTH) in the treatment of infantile spasms (IS). Methods　A total of 67 children who were admitted to the neurology ward of Guangzhou Women and Children's Medical Center from December 2019 to January 2022 and received intramuscular injection with ACTH for the treatment of IS, including 35 boys and 32 girls, with an age of (9.02±1.23) months old, were divided into 34 cases in the experimental group and 33 cases in the control group according to the random number table method. The control group used conventional intramuscular injection method. The experimental group used B-ultrasound to measure the thickness of the buttock muscle layer before intramuscular injection to determine the intramuscular injection depth, used an injection needle with a length of 3.7 cm for intramuscular injection in the buttocks. During the treatment period, the children were kept in a clean single room. The children were given overall care such as oral cavity, skin, medication, and infection prevention, and the parents of the children were provided with psychological care, health education, and other nursing interventions. The incidence of adverse reactions at the injection site (including induration at the injection site and hospital infection) and the effective completion rate within the treatment cycle were compared between the two groups. Independent sample t test and χ² test were used. Results　In the control group, the incidence of induration at the injection site was 84.85% (28/33), and the effective completion rate within the treatment cycle was 75.76% (25/33). In the experimental group, the incidence of induration at the injection site was 17.65% (6/34), and the effective completion rate within the treatment cycle was 97.06% (33/34). There were statistically significant differences in the above indexes between the two groups (both P<0.001). Conclusion　Intramuscular injection with ACTH assisted by B-ultrasound can effectively reduce the injection-related adverse events and improve the completion rate of treatment in children with IS.

Key words:

Infantile spasms, Adrenocorticotropic hormone, B-ultrasound, Intramuscular injection, Nursing

摘要：

目的　探讨促肾上腺皮质激素（ACTH）肌内注射治疗婴儿痉挛症（IS）的临床护理方法。方法　选取2019年12月至2022年1月入住广州市妇女儿童医疗中心神经内科病区接受ACTH肌内注射治疗的67例IS患儿进行调查研究。其中男35例，女32例，月龄（9.02±1.23）个月。按照随机数字表法分为试验组34例和对照组33例，对照组实施常规肌内注射方法，试验组实施B超辅助定位肌内注射方法（肌内注射前，使用B超测量臀部肌层厚度，以确定肌内注射深度，选用长度3.7 cm注射针头进行臀部肌内注射）。治疗期间所有患儿均入住洁净单间，其余的护理及健康宣教两组间均无差异。比较两组患儿注射部位不良反应发生率（包括注射部位硬结、院感）以及治疗周期内有效完成率。采用独立样本t检验和χ²检验。结果　对照组注射部位硬结发生率为84.85%（28/33），治疗周期内有效完成率为75.76%（25/33）；试验组注射部位硬结发生率为17.65%（6/34），治疗周期内有效完成率为97.06%（33/34）；两组患儿上述指标差异均有统计学意义（均P<0.001）。结论　B超辅助行ACTH肌内注射，可有效减少注射相关的不良事件，并提高IS患儿治疗完成率。

关键词:

婴儿痉挛症, 促肾上腺皮质激素, B超, 肌内注射, 护理