赛洛唑啉在儿童经鼻气管插管中的临床价值

Clinical value of Xylometazoline in nasotracheal intubation in children

目的测评赛洛唑啉滴鼻液联合利多卡因凝胶预处理鼻腔在减少儿童经鼻气管插管中鼻出血的效果。方法将需要经鼻气管插管扁桃体手术的儿童经患者及其家属同意分为赛洛唑啉组(n=43)和对照组(n=41)。七氟烷吸入诱导后,所有的患者首先均予2%的利多卡因凝胶润滑鼻孔,紧接着,赛洛唑啉组病人给予0.1%赛洛唑啉滴鼻液0.6 mL;对照组病人给予0.9%的氯化钠0.6 mL。而后评估插管及拔管后鼻出血情况及导管通过鼻腔通畅程度。结果赛洛唑啉组鼻出血发病率和严重程度显著低于对照组(6.98%vs 26.83%)(P<0.05),两组导管通过鼻腔通畅程度无差别。结论学龄前儿童经鼻气管插管时,0.1%赛洛唑啉滴鼻液与2%利多卡因凝胶联合预处理鼻腔可以显著降低鼻出血发生率及严重程度。

Objective To evaluate the effect of reducing epistaxis using xylometazoline nasal drops combined with lidocaine gel in pretreatment of nasotracheal intubation in children. Methods The nasotracheal intubation tonsil surgery for children were randomly divided into Xylometazoline group（ n = 43） and Control group（ n = 41）. After induction by sevoflurane,all patients were given 2% lidocaine gel or lubricating the nose.Thereafter,the Xylometazoline group of patients was given 0.1% xylometazoline nasal drops 0.6 mL,the control group of patients was given 0.9% sodium chloride 0.6 mL.The intubation,extubation nasal bleeding and the catheter through the nasal cavity smoothness were assessed. Results Nose bleeding incidence and severity in xylometazoline group was significantly lower than control group（ 6. 98% vs26. 83%）（ P0.05）,smoothness of catheter through the nasal cavity in the two groups was not different. Conclusion Preschool children with pernasal tracheal intubation,0. 1% Xylometazoline nasal drops combined with 2% lidocaine nasal gel pretreatment can significantly reduce the incidence and severity of epistaxis.