复方甘菊利多卡因凝胶应用于小儿尿道下裂术后的临床效果评估  

Clinical evaluation of Compound Chamomile and Lidocaine Hydrochloride Gel for postoperative hypospadias in children

作　　者：张诗屿 韩策 周辉霞 李品 马立飞 陶天 周晓光 陶元东 朱炜玮 赵扬 郭涛[1,2,3] 卓然 吕雪雪 ZHANG Shi-yu;HAN Ce;ZHOU Hui-xia;LI Pin;MA Li-fei;TAO Tian;ZHOU Xiao-guang;TAO Yuan-dong;ZHU Wei-wei;ZHAO Yang;GUO Tao;ZHUO Ran;Lü Xue-xue(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;Graduate School,Chinese PLA General Hospital,Beijing 100039,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附属八一儿童医院泌尿外科,北京100700 [3]解放军总医院研究生院,北京100039

出　　处：《中华男科学杂志》2021年第9期815-818,共4页National Journal of Andrology

基　　金：军队计生专项(18JS001);首都临床特色应用研究(Z181100001718008);首都卫生发展科研专项(2016-2-5091);卫生部行业科研专项(201402007)。

摘　　要：目的:探讨复方甘菊利多卡因凝胶用于小儿尿道下裂术后的临床疗效。方法:选取解放军总医院第七医学中心儿科医学部泌尿外科2020年1月至12月收治的116例远端型尿道下裂的患儿,用随机数字分组方法将患者随机分为两组,研究组58例,对照组58例。患者均于全麻下行Ⅰ期Snodgrass尿道成形术治疗,研究组在手术结束后于阴茎部位均匀涂抹复方甘菊利多卡因凝胶,对照组手术方式同研究组。比较两组手术时间、术后疼痛评分、术后水肿消退情况及术后患儿感染情况。数据采用t检验和χ;检验进行统计分析。结果:研究组与对照组患儿均在全麻下由同一手术者完成,手术过程顺利,均无大出血等意外情况发生。研究组与对照组年龄[(2.5±0.8)岁vs(2.4±0.6)岁]及平均手术时间[(95.6±14.5)min vs(97.1±15.2)min],差异均无统计学意义(P>0.05);两组均无切口感染病例。研究组术后2、24、48、72 h拆除敷料时疼痛评分(1.4±1.0、2.2±1.3、1.2±0.7、2.5±0.8)均低于对照组(2.6±1.3、3.9±1.6、1.6±0.9、3.7±1.8),术后2周水肿恢复人数研究组多于对照组(35例vs 19例),差异均有统计学意义(P<0.05)。结论:复方甘菊利多卡因凝胶可有效缓解尿道下裂患儿术后疼痛,减轻患儿术后水肿,加快患儿术后水肿恢复,适合尿道下裂患儿术后广泛使用。Objective:To evaluate the clinical efficacy of Compound Chamomile and Lidocaine Hydrochloride Gel for postoperative hypospadias in children.Methods:From January to December 2020,we treated 116 children with distal hypospadias in the Department of Urology,Department of Pediatrics and the Seventh Medical Center of the PLA General Hospital,58 by primary Snodgrass urethroplasty only(the control group)and the other 58 with Compound Chamomile and Lidocaine Hydrochloride Gel smeared on the penis postoperatively in addition(the trial group).We compared the operation time and postoperative pain score,edema regression and incidence of infection between the two groups,followed by statistical analysis using T test and Chi-square test.Results:All the operations were successfully completed by the same surgeon under general anesthesia.There were no statistically significant differences between the trial and control groups in age([2.5±0.8]vs[2.4±0.6]yr,P>0.05)or operation time([95.6±14.5]vs[97.1±15.2]min,P>0.05).No incision infection occurred in any of the cases.The pain scores at dressing removal were remarkably lower in the trial than in the control group at 2 hours(1.4±1.0 vs 2.6±1.3,P<0.05),24 hours(2.2±1.3 vs 3.9±1.6,P<0.05),48 hours(1.2±0.7 vs 1.6±0.9,P<0.05)and 72 hours after surgery(2.5±0.8 vs 3.7±1.8,P<0.05).Significantly more cases of edema regression were achieved in the trial than in the control group at 2 weeks postoperatively(35 vs 19,P<0.05).Conclusion:Compound Chamomile and Lidocaine Hydrochloride Gel can effectively relieve pain,reduce edema and accelerate edema regression after surgery in children with hypospadias,and therefore deserves wide clinical application.

关 键 词：甘菊利多卡因 疼痛 尿道下裂 术后 

分 类 号：R699.6[医药卫生—泌尿科学] R695[医药卫生—外科学]