复方甘菊利多卡因凝胶应用于小儿包皮环切术的疗效评估  

Therapeutic effect of compound chamomile and lidocaine hydrochloride gel for children with circumcision

作　　者：张媛[1,2] 赵扬 周辉霞 王蕊[1,2] 李品 马立飞 周晓光 陶天 曹华林 Zhang Yuan;Zhao Yang;Zhou Huixia;Wang Rui;Li Pin;Ma Lifei;Zhou Xiaoguang;Tao Tian;Cao Hualin(Faculty of Pediatrics,Chinese PLA General Hospital,Beijing 100700,China;Department of Urology,BaYi Children’s Hospital,Seventh Medical Center of Chinese PLA General Hospital,Beijing 100700,China)

机构地区：[1]解放军总医院儿科医学部,北京100700 [2]解放军总医院第七医学中心八一儿童医院泌尿外科,北京100700

出　　处：《发育医学电子杂志》2021年第3期228-232,共5页Journal of Developmental Medicine (Electronic Version)

基　　金：军队计生专项(18JS001);首都卫生发展科研专项(2016-2-5091);北京市科技计划(Z181100001718008)。

摘　　要：目的探讨复方甘菊利多卡因凝胶在小儿包皮环切术中的应用疗效。方法选取解放军总医院第七医学中心八一儿童医院泌尿外科2019年3月至9月收治的106例包茎患儿,根据随机数字表法将其分为研究组(51例)和对照组(55例)。研究组患儿在阴茎根部阻滞麻醉前、术毕包扎阴茎前于阴茎根部、阴茎体部及包皮口处涂抹复方甘菊利多卡因凝胶。对照组55例患儿采用传统包皮环切术进行治疗。比较两组手术时间、疼痛评分、术后包皮水肿发生率、切口感染发生率及其他并发症发生率的差异。采用t检验和χ^(2)检验进行统计分析。结果研究组及对照组所有患儿均在局麻下顺利完成手术。研究组与对照组平均手术时间[(33.4±4.5)与(35.1±5.6)min]及术后24 h疼痛评分[(1.2±0.4)与(1.1±0.3)分]比较,差异均无统计学意义(P>0.05);两组均无切口感染病例。研究组与对照组术中疼痛评分[(2.2±1.4)与(3.8±1.4)分]、术后1 h疼痛评分[(1.2±0.5)与(1.7±0.6)分]、术后4 d疼痛评分[(2.1±0.6)与(4.1±2.0)分]、术后2周包皮水肿发生率[3.9%(2/51)与18.2%(10/55)]以及其他术后并发症发生率[0.0%(0/51)与5.5%(3/55)]比较,研究组均低于对照组,差异有统计学意义(P<0.05)。结论复方甘菊利多卡因凝胶可有效预防和缓解儿童包皮环切术术中、术后所致的疼痛,减少术后包皮水肿的发生率,减轻患儿痛苦,值得临床参考应用。Objective To investigate the therapeutic effect of compound chamomile and lidocaine hydrochloride gel in children with circumcision.Methods 106 phimosis patients admitted in Department of Urology,Bayi Children's Hospital,Seventh Medical Center of PLA General Hospital from March to September 2019 were selected in the study.They were divided into study group(n=51)and control group(n=55)randomly according to random number table.Before the dorsal penile nerve blocking and the penis wrapped,compound chamomile and lidocaine hydrochloride gel was used at the base of the penis,the body of the penis and the prepuce orifice in study group.Patients in control group were treated with traditional circumcision.Operation time,pain score,incidence of postoperative foreskin edema,incidence of incision infection and other complications between the two groups were compared.Chi-square test and t test were used for statistical analysis.Results All the operations were successfully completed in two groups with the local anesthesia.There was no significant difference in operation time[(33.4±4.5)vs(35.1±5.6)min]and VAS score of postoperative 24 h[(1.2±0.4)vs(1.1±0.3)]between the two groups(P>0.05).There was no case of incision infection in the two groups.Intraoperative pain score in study group and the control group[(2.2±1.4)vs(3.8±1.4)],1 h postoperative pain score[(1.2±0.5)vs(1.7±0.6)],4 d postoperative pain score[(2.1±0.6)and(4.1±2.0)],the rate of foreskin edema at 2 weeks after operation[3.9%(2/51)vs 18.2%(10/55)]and the rate of other postoperative complications[0.0%(0/51)vs 5.5%(3/55)]were compared,and those in study group were lower than those in control group with statistical significance(P<0.05).Conclusions Compound chamomile and lidocaine hydrochloride gel takes advantages of reducing perioperative,postoperative pain and incidence of post operation edema in children with circumcision.It is worthy of clinical application.

关 键 词：利多卡因 包茎 包皮环切术 疼痛 包皮水肿 儿童 

分 类 号：R726.1[医药卫生—儿科]