复方阿替卡因应用于经鼻内镜下鼻腔泪囊造口术中的临床研究
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Clinical effect of compound articaine in endoscopic endonasal dacryocystorhinostomy
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    摘要:

    目的:观察复方阿替卡因(必兰)浸润麻醉在经鼻内镜辅助下鼻腔泪囊造口(endoscopic endonasal dacryocystorhinosto-my,EN-DCR)联合支架植入术中的效果。方法:采取前瞻性研究,选取需行经鼻内镜下左侧鼻腔泪囊造口术患者共69名,随机分为对照组30例以2%利多卡因浸润麻醉及实验组39例以复方阿替卡因行浸润麻醉,比较2组的麻醉显效率、术中疼痛程度和术前后心率血压及术中出血情况,采用卡方检验及独立样本t检验的方法进行统计分析。结果:实验组和对照组的疼痛视觉模拟评分(visual analogue scale of pain,VASp)分别为(44.36±11.65) mm和(52.67±12.02) mm,2组间差异有统计学意义(t=2.897,P=0.005);2组患者术中出血量比较,实验组为(3.87±0.95) mL,对照组为(4.17±0.95) mL,差异有统计学意义(t=2.698,P=0.007);实验组麻醉显效率为89.74%,与对照组的76.67%相比差异无统计学意义(?字2=1.298,P=0.255)。术前、术后血压及心率的比较,差异无统计学意义(P>0.05)。结论:复方阿替卡因应用于经鼻内镜下鼻腔泪囊造口联合支架植入术中,效果可靠,是一种替代2%利多卡因浸润麻醉的改良局部麻醉药物。

    Abstract:

    Objective:To investigate the clinical effect of compound articaine(Primacaine) for infiltration anesthesia in endoscopic en-donasal dacryocystorhinostomy(EN-DCR) combined with stent implantation. Methods:A prospective study was performed for 69 pa-tients who planned to undergo EN-DCR in the left nasal cavity,and these patients were randomly divided into control group with 30 patients(2% lidocaine for infiltration anesthesia) and experimental group with 39 patients(compound articaine for infiltration anes-thesia). The two groups were compared in terms of effective proportion,visual analogue scale of pain(VASp) during surgery,preoper-ative/postoperative heart rate and blood pressure,and intraoperative bleeding. The chi-square test and the independent samples t-test were used for statistical analysis. Results:There were significant differences between the experimental group and the control group in VASp score(44.36±11.65 vs. 52.67±12.02,t=2.897,P=0.005) and intraoperative blood loss[(3.87±0.95) mL vs. (4.17±0.95) mL,t=2.698,P=0.007]. There was no significant difference in effective proportion between the experimental group and the control group(89.74% vs. 76.67%, ?字2=1.298,P=0.255). There were also no significant differences between the two groups in blood pressure and heart rate before and after surgery(P>0.05). Conclusion:Compound articaine has a reliable effect in EN-DCR combined with stent implantation and is a modified local anesthetic which can replace 2% lidocaine for infiltration anesthesia.

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李欣,刘朝晖,陆孟婷,张黎.复方阿替卡因应用于经鼻内镜下鼻腔泪囊造口术中的临床研究[J].重庆医科大学学报,2019,(5):633-

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  • 在线发布日期: 2019-06-05
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