摘要
目的 探讨利多卡因胶浆及康复新液对留置鼻胆管患者舒适度的影响。方法 将行经内镜鼻胆管引流术（Endoscopic Nasobiliary Drainage, ENBD）术后发生中、重度不舒适的138例患者随机分为3组，分别向各组患者口鼻腔内喷入康复新稀释液喷雾（A组）、利多卡因胶浆稀释液喷雾（B组）、5%葡萄糖注射液喷雾（C组），每组各46例。采用重复测量方差分析、卡方检验等方法比较3组患者在置管后6h、24h及48h的舒适度评分、口鼻咽部不适反应、口咽并发症及睡眠状况等。结果 3组各时间点改善患者舒适度的效果为 B 组>A 组>C 组，差异具有统计学意义（P＜0.05）；A组在各时间点在减少口咽并发症的效果优于B组和C组（P <0.05）；B组在各时间点缓解咽喉疼痛效果优于A组和C组（P＜0.05）；A、B两组患者在置管后48h睡眠情况优于C组（P＜0.05）。结论 康复新稀释液和利多卡因胶浆稀释液均能有效改善留置鼻胆管患者口咽部舒适度，利多卡因胶浆稀释液能有效缓解口咽疼痛症状，康复新稀释液能减少口咽并发症的发生，两种药物喷雾均能够有效改善患者的睡眠质量。护理人员应根据口鼻咽不适反应的类型为患者提供个性化护理。
关键词： 经内镜鼻胆管引流术；药物喷雾；口鼻咽部舒适度；康复新液；利多卡因胶浆
Abstract
Objective To investigate the effects of lidocaine mucilage and Kangfuxin solution on comfort in patients with indwelling nasobiliary tubes. Methods A total of 138 patients who experienced moderate to severe discomfort after Endoscopic Nasobiliary Drainage (ENBD) were randomly divided into three groups. Group A received diluted Kangfuxin solution spray, Group B received diluted lidocaine mucilage spray, and Group C received 5% glucose solution spray, with 46 patients in each group. Comfort scores, oronasopharyngeal discomfort reactions, oropharyngeal complications, and sleep quality were compared among the three groups at 6h, 24h, and 48h after tube placement using repeated measures ANOVA and chi-square tests. Results The improvement in comfort at all time points was most significant in Group B, followed by Group A, and then Group C, with statistically significant differences (P < 0.05). Group A showed better effects in reducing oropharyngeal complications compared to Groups B and C at all time points (P < 0.05). Group B demonstrated superior relief of throat pain compared to Groups A and C at all time points (P < 0.05). Both Groups A and B showed better sleep quality than Group C at 48h after tube placement (P < 0.05). Conclusion Both diluted Kangfuxin solution and diluted lidocaine mucilage can effectively improve oropharyngeal comfort in patients with indwelling nasobiliary tubes. Diluted lidocaine mucilage significantly alleviates throat pain, while diluted Kangfuxin solution reduces oropharyngeal complications. Both sprays improve sleep quality. Nursing staff should provide personalized care based on the type of oronasopharyngeal discomfort reactions.
Key words： Endoscopic Nasobiliary Drainage (ENBD); Pharmaceutical spray; Oro-nasopharyngeal comfort; Kangfuxin solution; Lidocaine mucilage
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