低温3%氯化钠溶液术中冲洗在成年人扁桃体等离子切除术中的应用  

Applicaion of intraoperative irrigation with hypothermic 3%sodium chloride solution in plasma tonsillectomy in adults

作　　者：董慧 杜美兰[1] 潘爱芬[1] 张新梅[1] 殷雪群[1] 鞠铮宇 Dong Hui;Du Meilan;Pan Aifen;Zhang Xinmei;Yin Xuequn;Ju Zhengyu(Department of Anesthesiology and Surgery,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院麻醉手术科,苏州215006

出　　处：《中国实用护理杂志》2022年第16期1207-1211,共5页Chinese Journal of Practical Nursing

基　　金：2020年苏州大学附属第一医院护理科研项目(HLYJ-2020-06)。

摘　　要：目的探讨低温3%氯化钠溶液术中冲洗对成年人扁桃体等离子切除术手术效果和术后创面疼痛的干预效果。方法将2020年1—12月在苏州大学附属第一医院行成年人扁桃体等离子切除术120例患者按照随机数字表法分为观察组A、观察组B、观察组C和对照组,每组30例。观察组A术中使用低温3%氯化钠溶液;观察组B术中使用常温3%氯化钠溶液;观察组C术中使用低温0.9%氯化钠溶液;对照组术中使用常温0.9%氯化钠溶液。比较4组患者手术视野质量、手术时间、术中出血量、气管导管拔除时间以及术后24、48、72 h患者疼痛程度。结果观察组A手术视野质量评分为(2.07±0.87)分,低于观察组B、观察组C和对照组的(2.57±0.73)、(2.60±0.56)、(3.10±0.66)分,差异有统计学意义(t=2.71、2.89、5.61,均P<0.01);观察组A、观察组B和观察组C术中出血量分别为(9.13±1.74)、(10.03±2.81)、(10.50±2.09)ml,少于对照组的(15.23±3.64)ml,差异有统计学意义(t=8.85、7.54、6.87,均P<0.01)。术后24 h,观察组A、观察组B和观察组C的疼痛数字评分法(NRS)评分分别为(3.23±0.77)、(3.53±0.63)、(3.80±0.89)分,低于对照组的(4.43±1.17)分;术后48 h,观察组A的NRS评分为(2.37±0.72)分,低于对照组的(2.93±0.83)分,差异有统计学意义(t值为2.77~5.25,均P<0.01)。4组患者手术时间、气管导管拔除时间、术后72 h的NRS评分比较差异无统计学意义(P>0.05)。结论术中使用低温3%氯化钠溶液冲洗可减少成年人扁桃体等离子切除术患者术中出血量,增加手术视野清晰度,并能有效减轻术后疼痛。Objective To investigate the effects of intraoperative irrigation with hypothermic 3%sodium chloride solution on surgery effect and post-tonsillectomy pain in adults.Methods A total of 120 adult patients with the plasma tonsillectomy from January to December 2020 in the First Affiliated Hospital of Soochow University were divided into observation group A,observation group B,observation group C and control group according to random number table method,with 30 cases in each group.During operation,observation group A used hypothermia 3%sodium chloride,observation group B used room temperature 3%sodium chloride,observation group C used hypothermia 0.9%sodium chloride,control group used room temperature 0.9%sodium chloride.The quality of surgical field quality,operation time,blood loss in operation,duration of catheter,the postoperative wound pain at 24,48,72 h after operation were compared among four groups.Results The surgical field quality scores were(2.07±0.87)points in the observation group A,significantly lower than in the observation group B(2.57±0.73)points,observation group C(2.60±0.56)points and control group(3.10±0.66)points,the differences were statistically significant(t=2.71,2.89,5.61,all P<0.01).Amounts of blood loss in operation were(9.13±1.74),(10.03±2.81),(10.50±2.09)ml in the observation group A,observation group B and observation group C,significantly lower than in the control group(15.23±3.64)ml,the differences were statistically significant(t=8.85,7.54,6.87,all P<0.01).At 24 h after operation,the scores of Numerical Rating Scale(NRS)were(3.23±0.77),(3.53±0.63),(3.80±0.89)points in the observation group A,observation group B and observation group C,significantly lower than in the control group(4.43±1.17)points.At 48 h after operation,the scores of NRS were(2.37±0.72)points in the observation group A,significantly lower than in the control group(2.93±0.83)points,the differences were statistically significant(t values were 2.77-5.25,all P<0.01).There was no significant difference in op

关 键 词：成年人 扁桃体切除术 高渗溶液 氯化钠 低温等离子 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]