薄荷水喷入对留置鼻胆管患者口鼻咽喉并发症的预防与缓解效果

Effect of mint water spraying on the oropharyngeal nasal complications of the patients with indwelling nasal biliary drainage sets

目的探讨预防和缓解内镜鼻胆管引流术（endoscopicnaso—biliary drainage，ENBD）后留置鼻胆管患者13鼻及咽喉部不适的方法。方法将90例ENBD术后留置鼻胆管患者按随机数字表法分为观察组和对照组各45例。观察组采用薄荷水进行咽喉喷入，对照组采用生理盐水喷入。比较两组患者鼻胆管置入术后6，30，54h口咽干燥、咽喉疼痛、吞咽不适、13咽并发症、鼻腔不适的发生情况。结果观察组患者在ENBD术后6h吞咽不适、鼻腔不适、13咽并发症评分均明显低于对照组[（4．33±1．29）比（5．67±1．11）分，（5．20±1．47）比（7．60±1．24）分，（0．80±0．56）比（1．27±0．59）分]，差异有统计学意义（t值分别为3．030，4．823，2．214；P〈0．05）；术后30h吞咽不适、鼻腔不适、口咽并发症评分均明显低于对照组[（3．33±0．90）比（4．87±0．64）分，（3．73±1．39）比（6．13±1．25）分，（0．53±0．64）比（1．07±0．70）分]，差异有统计学意义（t值分别为5．379，4．985，2．172；P〈0．05）；术后54h吞咽不适、鼻腔不适、13咽并发症评分均明显低于对照组[（2．47±0．83）比（4．53±0．92）分，（2．87±1．19）比（5．27±0．96）分，（0．27±0．46）比（0．93±0．70）分]，差异有统计学意义（t值分别为6．464，6．085，3．076；P〈0．01）。在咽喉疼痛方面，术后6，30h两组差异无统计学意义（P〉0．05），但随着时间推移，薄荷水的优势更加明显[术后54h（2．93±0．96）比（4．06±1．22）分；t=2．822，P〈0．01]。在口咽干燥方面，两组差异无统计学意义（P〉0．05）。结论使用自制的薄荷水进行咽喉喷入，对减轻患者ENBD术后留置鼻胆管的口鼻咽部不适效果明显。

Objective To investigate the methods of preventing and relieving the discomfort caused by indwelling after ENBD for the patients with indwelling nasal biliary drainage sets. Methods A total of 90 patients with indwelling nasal biliary drainage sets were recruited and randomly divided into experimental group （n =45）,who were received sprayed into throat with mint water, and control group （n = 45 ）, who were received sprayed into throat with saline. Dry mouth nasal biliary drainage sets, odynophagia, pharyngodynia, oropharyngeal complications and nasal irritation were assessed after 6, 30 and 54h therapy. Results The incidence of oropharyngeal complications [ （4.33 ± 1.29） vs （5.67 ± 1.11 ） ], odynophagia [ （5.20± 1.47） vs （7.60 ± 1.24） ] and nasal irritation [ （0.80 ±0.56） vs （ 1.27 ±0.59） ] in experimental group were less than that in control group after 6 hours （ t = 3. 030,4. 823,2. 214, respectively; P 〈 0.05 ）. After 30 hours, the incidence of oropharyngeal complications [ （3.33 ±0.90） vs （4.87±0.64） ] ,odynophagia [ （3.73 ± 1.39） vs （ 6.13 ± 1.25 ）], nasal irritation [ （ 0.53 ±0. 64 ） vs （ 1.07 ± 0.70） ] in experimental group were less than that in control group （ t = 5. 379,4. 985,2. 172, respectively; P 〈 0.05 ）. And after 54 hours, the incidence of oropharyngeal complications, odynophagia, nasal irritation in experimental group were less than that in control group [（2.47±0.83） vs （4.53 ±0.92）,（2.87 ±1.19） vs （5.27 ±0.96）,（0.27 ±0.46） vs （0.93 ± 0.70） ,respeetively;P 〈0.01 ]. Postoperative pharyngodynia after the initial in 6 hours and 30 hours has no significant difference （ P 〉 0.05 ）. While after 54 hours, the advantages of mint water became more obvious [ （2.93 ±0.96） vs （4.06 ± 1.22）, t =2. 822 ,P 〈0.05 ]. No significant difference was found in the incidence of pharyngodynia （ P 〉 0.05 ）. Conclusions Spray homemade mint water into pharyngeal of patients can release postoperative discomfort caused by indwelling nasal biliary.