2%利多卡因在新型冠状病毒肺炎核酸筛检鼻咽拭子取样方法中的应用效果

Effect of 2%lidocaine on the sampling method of nasopharyngeal swabs for nucleic acid screening of COVID-19

目的观察2%利多卡因在新型冠状病毒肺炎核酸筛检鼻咽拭子取样方法中的应用效果。方法选取2020年2—3月于泰康同济(武汉)医院新冠肺炎隔离病房住院首次行病毒核酸检测的患者共126例,采用随机数字表法分为试验组(利多卡因滴鼻组)和对照组(常规采样组),各63例。对照组采用常规鼻咽拭子采样方法采样,试验组在患者采样前5 min滴2%利多卡因0.3 ml单侧鼻孔,2组均由同一操作人员采样。比较2组一次采样成功率,不适(恶心、呕吐等)发生率,患者鼻咽部舒适度及采样前后应激指标(采样前、采样后2 min脉搏、血压)变化。结果试验组一次采样成功率为100.00%,高于对照组的90.48%(χ^(2)=6.300,P=0.028);试验组患者恶心、呕吐发生率为14.29%,低于对照组的33.33%(χ^(2)=6.300,P=0.012);试验组鼻咽部重度不适1例(1.59%),少于对照组的鼻咽部重度不适13例(20.63%)(χ^(2)=11.571,P=0.001)。2组患者在鼻咽拭子采样后脉搏、血压均呈不同程度升高,但组间比较差异无统计学意义(P>0.05)。结论2%利多卡因在新型冠状病毒肺炎核酸筛检鼻咽拭子取样方法中的应用效果良好,患者鼻咽部不适缓解,恶心、呕吐发生率降低,一次性采样成功率提高,更体现了人文关怀的护理理念,值得临床推广应用。

Objective To observe the effect of 2%lidocaine on the sampling method of nasopharyngeal swabs for nucleic acid screening of COVID-19.Methods A total of 126 patients who received the first viral nucleic acid test from the COVID-19 isolation ward in Taikang Tongji(Wuhan)hospital from February 2020 to March were selected.The patients were randomly divided into experimental group(lidocaine nasal drip group)and control group(routine sampling group),with 63cases in each group.The control group was sampled by conventional nasopharyngeal swab sampling method,and the experimental group was dripped with 0.3 ml of 2%lidocaine 5 minutes before sampling.Both groups were sampled by the same operator.The success rate of one-time sampling,the incidence of discomfort(nausea,vomiting,etc.),the comfort of patients’nasopharynx and the changes of stress indexes(pulse and blood pressure before and 2 minutes after sampling)were compared between the two groups.Results The success rate of one-time sampling in the experimental group was 100.00%,which was higher than 90.48%in the control group(χ^(2)=6.300,P=0.028).The incidence of nausea and vomiting in the experimental group was 14.29%,lower than 33.33%in the control group(χ^(2)=6.300,P=0.012).One case(1.59%)of severe nasopharynx discomfort in the experimental group was less than 13 cases(20.63%)of severe nasopharynx discomfort in the control group(χ^(2)=11.571,P=0.001).After nasopharyngeal swab sampling,the pulse and blood pressure of the two groups increased in varying degrees,but there was no significant difference between the two groups(P>0.05).Conclusion 2%lidocaine has a good effect in COVID-19 nucleic acid screening for nasopharyngeal swabs sampling.The patients’nasopharynx discomfort was relieved,the incidence of nausea and vomiting was reduced,and the success rate of one-time sampling was improved.It also embodies the nursing concept of humanistic care,which is worthy of clinical application.