复方利多卡因乳膏作为超声耦合剂的声学物理学与临床应用

Acoustic Physical Parameters and Clinical Applications of Compound Lidocaine Cream as an Ultrasound Coupling Agent

目的:探讨复方利多卡因乳膏作为超声耦合剂的可能性。方法:(1)以临床常用超声耦合剂Aquasonic 100为对照物,采用声学物理测定法对复方利多卡因乳膏的声速、声阻抗和声衰减数值等进行测定。(2)60例行单纯右颈内静脉穿刺置管术肿瘤患者,采用随机数字表法分为Aquasonic 100耦合剂组(A组)和Aquasonic 100耦合剂+复方利多卡因乳膏复合组(AL组),每组30例,进行超声引导下的中心静脉穿刺置管术,保存穿刺时超声图像,进行清晰度评分;记录从穿刺开始到穿刺成功置管的时间;观察术后穿刺部位疼痛评分、红肿、血胸及气胸等并发症发生情况。结果:复方利多卡因乳膏与Aquasonic 100耦合剂相比较,两者声学参数相近。AL组超声图像清晰度较A组明显高(P<0.05),穿刺时间明显短(P<0.05)。术后一天VAS疼痛评分较低(P<0.01),两组穿刺部位红肿发生率低,均无气胸、血胸等穿刺并发症发生。结论:复方利多卡因乳膏似可作为一种超声耦合剂应用于浅表部位超声,具有可行性和临床操作优势。

Objective:To explore the possibility of compound lidocaine cream as an ultrasound coupling agent.Methods:(1)Sound velocity,acoustic impedance and attenuation of compound lidocaine cream were determined by acoustic physical method compared to a widely-used clinical ultrasound coupling agent Aquasonic 100.(2)Sixty cancer patients underwent right internal jugular vein catheterization were randomly divided into Aquasonic 100 coupling agent group(group A)and Aquasonic 100 coupling agent combined of compound lidocaine cream group(group AL)by a random number table,30 cases in each group.Ultrasound guided puncture and catheterization of right neck central venous was done by the same anesthesiologist and the blood vessel ultrasound images were preserved to score the image definition.The times from puncture to successful catheterization and the pain scores of visual analogue scale(VAS)at puncture site 1 day after the operation were recorded.Complications 1 day after the operation such as redness,aerothorax and haemothorax were observed.Results:Sound velocity,acoustic impedance and attenuation of compound lidocaine cream were similar to those of Aquasonic 100.The scores of image clarity were significantly higher in group AL than those in group A(P<0.05).The times from puncture to successful catheterization were shorter in group AL.The scores of VAS in puncture site were much lower in group AL than those in group A(P<0.01).The incidences of puncture site redness and swelling were very low,and aerothorax and haemothorax did not occur in both groups.Conclusion:Compound lidocaine cream as a kind of ultrasonic coupling agent has feasibility and clinical advantages in superficial ultrasound.