Background: A woman, who had tuberculosis, needed daily injection of streptomycin during the 3-month intensive period, but by 2 months, lumps and nodules appeared on the skin of her buttocks, and she still felt persistent pain during and after the injection by applying heat every day, and the doctor felt difficulty in pushing the drug in before the scheduled course of treatment, so she had to give up the streptomycin treatment.
In general, people occasionally get injections, and there is no big problem, but in some people the skin will have more serious reactions, especially when injecting certain kinds of drugs for many times and for a long time, the skin will be red, swollen and nodular, and when this happens, how should it be handled?
Intramuscular injection (referred to as intramuscular injection) is a common clinical route of drug administration, which generally causes fewer systemic skin problems, occasionally rash, angioneurotic edema, itching, etc. This is mainly due to drug-induced allergic reactions, which are generally rare and mostly related to the patient’s allergic constitution, and severe rash can spread throughout the body, manifesting as extensive erythema, edema, and even blistering, erosion, and sometimes Choking, vomiting, abdominal pain, when there is shortness of breath, shortness of breath, decreased blood pressure, rapid pulse, sweating and other shock manifestations, can be life-threatening.
Local redness, swelling, hard nodules, pain and itching sometimes appear at the injection site; local hard nodules are more common. It not only brings pain to the patient, affects drug absorption and efficacy, but also is one of the causes of treatment interruption.
There are many reasons for the occurrence of sclerosis in myoinjection, mainly because of slow absorption of drugs or insufficient depth of injection, and related to drug type, injection method and physical factors.
I. Drug factors
1, the solubility of some drugs is very small, such as procaine penicillin oil, progesterone oil, etc., intramuscular injection at the place often due to slow absorption and the formation of hard nodules. Another example is chloroquine, oxytetracycline, lignocaine and cortisone, digoxin, etc., in the injection site is very easy to precipitate drug crystals, difficult to absorb, the formation of lumps.
2, there are also written to stimulate the stronger drugs, such as penicillin potassium salt, chloramphenicol, streptomycin, kanamycin, lincomycin and aminophylline, atropine sulfate, iron for the treatment of anemia, etc., after injection are prone to hard nodules, pain phenomenon.
Second, injection factors
1, because the depth of myoinjection is not deep enough, myoinjection drug injected into the fat layer, but not reach the muscle layer, the drug solution in the fat layer for a long time, crystallization precipitation to stimulate the tissue, causing the proliferation of fibrous tissue, wrapped around the crystals to form hard knots.
2, in the same site repeatedly injected several times, the drug in the local residence time is prolonged, accumulation and the formation of hard knots. If insulin is injected intramuscularly for a long time, local skin nodules, erythema and even infection will appear.
3, the patient receives the injection when the spirit is overly nervous, the muscle can not relax and caused; or is relatively fat, resulting in the needle piercing depth is not enough, and the injection of the drug into the fat layer, because there are fewer blood vessels, not easily absorbed by the tissue, so that the injection site in the phenomenon of hard knots.
4. The amount of drug given each time is too much, more than 5mL increases the chance of forming hard knots.
Third, physical factors.
1.When the patient is bedridden for a long time, his muscle activity is relatively reduced, and the blood supply to the local tissues is also reduced, so that the absorption rate of the drug becomes slower and hard knots are gradually formed.
2, vaccination, such as inoculation of the hard nodules caused by the vaccination of the Bai Bai, the inoculation site has redness, swelling, heat, pain and itching and can be accompanied by low fever and other symptoms.
3.People with scars.
Softening hard knots and promoting drug absorption
1, wet hot compress: wet towel dipped in hot water 60 ~ 70 ℃ (can also add 50% magnesium sulfate solution), wrung out and put on the affected area, every 3-5 minutes to change 1 time, for 20-30 minutes, 3-4 times a day. If with massage effect will be better. This method can relax the muscles, promote blood circulation, accelerate the absorption of the injection site, play a role in reducing swelling and dispersing the knots. The earlier the hot compress the better the effect.
2.Potato slicing method: fresh potatoes cut into slices, about 0.5-1 cm thick paste on the affected area, (potato slices slightly larger than the hard knots), fixed with gauze strips, daily change a piece, generally external application for a few days can make the hard lumps subside. This is a common recommendation of our medical staff, no potatoes can also be used instead of fresh white radish. You can also cut up fresh potatoes, mash them with vinegar and apply them to the hard lumps.
3.Wounded dampness pain relief paste method (pregnant women should not be used): cut wounded dampness pain relief paste into the appropriate size and paste it on the hard knots, and then hot water bags with hot water for 10-15 minutes, 1-2 times a day, generally 2-3 days to see results.
4.Yunnan Baiyao external application method: take a bottle of Yunnan Baiyao with white vinegar, pinch into a thin cake and paste on the hard knot (cake slightly larger than the hard knot) fixed 2-3 days effective.
5.Cactus external application: take a piece of cactus, remove the mango, pound it like mud, put it on the hard knot, cover it with gauze and fix it, once a day.
6, ice chips rubbing method: the method is to take 2-3 grams of ice chips (available in pharmacies), dissolved in 75% alcohol 30 ml, ice chips dissolved, with sterile gauze dipping solution rubbing hard knots, 5-10 minutes each time, once a day, often 3-5 days to see results.
7, moxibustion: take a moxa strip, ignite and smoke the hard nodes directly, the patient to feel a sense of warmth, comfort, in order not to feel the skin is very hot as degree.
These can be operated at home, easy to do, of course, you can also go to the hospital for physical therapy, safe and effective. Physiotherapy treatments include magnetic therapy, ultrashort wave, microwave, laser and other methods, all of which have anti-inflammatory, swelling, pain relief, promote local blood circulation, promote drug absorption and soften hard nodes.
Special Reminder
Parents of children who are often sick ask doctors to give their children intramuscular injections on the grounds that it is troublesome for them to take medication. These children, often due to recurrent respiratory infections, tonsillitis, pneumonia or enteritis, receive multiple intramuscular drug injections. These drugs are mainly antibiotics and antipyretic analgesics, of which penicillin potassium salt is very irritating and repeated injections are most likely to cause local sclerosis and even muscle fibrosis, causing deformities. The more the number of intramuscular injections in the buttocks, the more the chance of developing the disease; the earlier the age of onset, the more serious the disease. Therefore, in order to prevent the disease from occurring, it is recommended to use drugs rationally and avoid injections whenever they can be taken orally. If it is necessary to inject intramuscularly, the course of treatment should preferably be 3-5 days, and at most no more than 2 weeks. During the course of treatment, apply hot towels externally to the intramuscular injection site twice a day for 10 minutes each time. For children with too many injections, it is advisable to do physiotherapy after each course of treatment to improve the blood circulation of locally damaged tissues and promote the healing of locally damaged tissues.