利多卡因联合庆大霉素含漱对小儿鼾症术后疼痛及8-iso-PG、MnSOD水平的影响  

The effect of lidocaine combined with gentamicin gargle on postoperative pain,8-iso-PG and MnSOD levels in children with snoring

作　　者：杨娟娟[1] 杨梅梅 张新海[1] 陶雯燕 刘雪梅 尹兴红[1] 杨文倩 YANG Juan-juan;YANG Mei-mei;ZHANG Xin-hai(Department of Otolaryngology Head and neck surgery,Fuyang People's Hospital,Fuyang Anhui 236000,China)

机构地区：[1]阜阳市人民医院耳鼻咽喉头颈外科,安徽阜阳236000

出　　处：《临床和实验医学杂志》2022年第2期218-222,共5页Journal of Clinical and Experimental Medicine

基　　金：阜阳市卫生健康委科研课题(编号:FY2019-040);安徽省自然科学基金(编号:2019B00185)。

摘　　要：目的观察利多卡因联合庆大霉素含漱对小儿鼾症术后疼痛及8-异构前列腺素(8-iso-PG)、锰超氧化物歧化酶(MnSOD)水平的影响。方法前瞻性选取阜阳市人民医院耳鼻咽喉头颈外科于2019年3月至2020年3月收治的小儿鼾症患者100例,所有患者均择期在气管插管麻醉下行扁桃体和(或)腺样体切除术治疗。根据奇偶数分组法分为两组,其中对照组50例术后给予冰袋冰敷等常规处理,同时联合0.9%氯化钠溶液含漱作为安慰剂,观察组50例术后在常规处理基础上给予利多卡因联合庆大霉素含漱。记录两组术后疼痛程度、咽部黏膜消肿时间、首次进流食时间、住院时间和并发症情况,检测两组8-iso-PG、MnSOD的水平。结果观察组术后24、48、72 h时的疼痛视觉模拟(VAS)评分分别为(4.12±0.54)、(3.24±0.43)、(2.32±0.34)分,均明显低于对照组[(5.08±0.51)、(4.18±0.47)、(3.51±0.42)分],差异均有统计学意义(P<0.05)。观察组咽部黏膜消肿时间、首次进流食时间、住院时间为(28.89±3.64)h、(4.91±0.86)d、(5.04±0.91)d,均短于对照组[(33.05±4.51)h、(5.85±1.04)d、(5.91±1.13)d],差异均有统计学意义(P<0.05)。术后72 h,观察组8-iso-PG为(107.25±16.42)ng/L,显著低于对照组[(121.33±18.56)ng/L],MnSOD为(6.58±1.21)U/mL,显著高于对照组[(6.04±1.14)U/mL],差异均有统计学意义(P<0.05)。观察组术后发热和总并发症的发生率分别为4.00%和6.00%,低于对照组(16.00%、28.00%),但总出血、饮水反流、感染的发生率与对照组比较,差异无统计学意义(P>0.05)。结论利多卡因联合庆大霉素含漱可有效减轻小儿鼾症术后的疼痛程度,减轻机体应激反应,促进术后康复,且可降低并发症的发生。Objective To observe the effects of lidocaine combined with gentamicin gargle on postoperative pain and 8-Isoprostaglandin(8-iso-PG)and manganese superoxide dismutase(MnSOD)levels in children with snoring.Methods One hundred cases of pediatric snoring patients who were admitted to the Department of Otorhinolaryngology Head and Neck Surgery,Fuyang People's Hospital from March 2019 to March 2020 were prospectively selected.All patients were treated with tonsillectomy and/or adenoidectomy under tracheal intubation anesthesia.According to the odd and even number grouping method,50 cases in the control group were given conventional treatments such as ice packs and gargle with normal saline as a placebo.Fifty patients in the observation group were given lidocaine combined with gentamicin to gargle on the basis of routine treatment.The postoperative pain degree,pharyngeal mucosal swelling time,first fluid feeding time,hospitalization stay and complications were recorded in the two groups,and the levels of 8-iso-PG and MnSOD were detected in the two groups.Results The VAS scores of the observation group at 24,48 and 72 h after operation were(4.12±0.54),(3.24±0.43),and(2.32±0.34)pionts,respectively,which were significantly lower than those in the control group[(5.08±0.51),(4.18±0.47),(3.51±0.42)pionts],the differences were statistically significant(P<0.05).The swelling time of the pharyngeal mucosa,the first fluid feeding time,and the hospitalization stay in the observation group were(28.89±3.64)h,(4.91±0.86)d,and(5.04±0.91)d,which were shorter than those in the control group[(33.05±4.51)h,(5.85±1.04)d,(5.91±1.13)d],the differences were statistically significant(P<0.05).72 hours after the operation,the level of 8-iso-PG in the observation group was(107.25±16.42)ng/L,which was significantly lower than that in the control group[(121.33±18.56)ng/L],and the level of MnSOD was(6.58±1.21)U/mL,which was significant higher than that in the control group[(6.04±1.14)U/mL],the differences were statistically significa

关 键 词：小儿鼾症 利多卡因 庆大霉素 疼痛 应激反应 8-异构前列腺素 锰超氧化物歧化酶 并发症 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]