| [Objective]To investigate the effects of XuanmaiLiyan spray on pharyngeal pain,oropharyngeal complications,dysphagia,oropharynx dryness,postoperative sleep quality in patients with nasal intubation after endoscopic mucosal dissection(ESD)and endoscopic total resection(EFR),in comparison with the local spray of Kangfuxin Solution.Unplanned extubation and medical cost in the two groups were also observed,to clarify the efficacy,economy and safety of XuanmaiLiyan Spray before its promotion for clinical use.[Methods]Eighty patients from the Department of Digestive Endoscopy of Jiangsu Traditional Chinese Medicine Hospital were included in this study.All patients needed ESD and EFR treatment after being diagnosed as gastric/intestinal adenoma,early cancer and so on.Due to the big wounds after operation,nasogastric(NG)tubes were intubated in order to observe and prevent postoperative complications.During the period of NG tube intubation,all patients had different degrees of sore throat,dry throat,swallowing discomfort and sleep problems.Subjects were randomly divided into observation group and control group,40 cases in each group.On the basis of postoperative nursing routine,the observation group was evaluated 2 hours after the patients returned to the ward,and the patient was awake and able to cooperate correctly.XuanmaiLiyan spray was used externally once every 2h during the day and on demand at night until the symptoms of the pharynx were relieved.In comparison,Kangfuxin solution was used in the control group with the same method.The curative effect was evaluated before and 0,6,30 and 54 hours after operation.General data including age,education level,payment mode,occupation,gender,surgical mode,intraoperative tracheal intubation and postoperative tube retention time were compared between the two groups before surgery to ensure the baseline uniformity.Pharyngeal visual analogue scale(VAS)score,oropharyngeal complications,swallowing discomfort,oropharynx dryness and sleeping condition of the two groups after treatment were compared to determine the difference in efficacy.Medical costs of the two groups,including the number of postoperative hospital stays and the cost of drugs,were also compared to identify more advantageous interventions in clinical practice.Furthermore,unplanned extubation rates.ancd adverse drug reactions were analyzed to evaluate the difference of safety between the two groups.Finally,the clinical effects of the two groups were judged from the total efficacy.[Results]1.Comparison of general information between the two groups before surgery,including the gender,age,surgical mode,and postoperative retention time of the two groups.The p values were all>0.05,indicating that the basic data of the two groups were not statistically different and were comparable.2.The VAS score of pharyngeal pain and oropharyngeal complications were compared between the two groups after treatment.30 hours after operation,the VAS scores of pharyngeal VAS pain and oropharyngeal complication in the observation group(3.05±0.78 and 0.54±0.51,respectively)were significantly lower than the scores in the control group(3.52±1.08 and 0.83±0.56,respectively)(P<0.05),indicating that XuanmaiLiyan spray had a significant effect in relieving the pharyngeal pain and discomfort in patients with NG tube intubation after endoscopic surgery.3.Comparison of swallowing discomfort and oropharynx dryness between the two groups after treatment.With the prolongation of time after operation,the swallowing discomfort and oropharyngeal dryness in both groups decreased gradually.Thirty hours after operation,the swallowing discomfort and dry mouth and throat in the observation group were lower than those in the control group(P<0.05),indicating that XuanmaiLiyan spray can better alleviate swallowing discomfort and dry mouth and throat in patients than Kangfuxin solution.4.Comparison of sleep quality between the two groups.There was no significant difrerence in sleep quality between the two groups before operation(P>0.05).Thirty hours after operation,the sleep quality of patients in the observation group was significantly higher than those in the control group(P<0.05),indicating that XuanmaiLiyan spray could improve the sleep condition of patients compared with Kangfuxin solution.5.Comparison of medical costs between the two groups.The mean cost of drugs in the observation group was 9.37 yuan,while that in the control group was 31.35 yuan.The mean price of drugs used in the control group was 3.35 times higher than that in the observation group.The length of hospital stay(LHS)in the observation group was3.21±0.48 days,while that in the control group was 3.41±0.65 days,with no statistical significance(P>0.05).This data indicates that the use of XuanmaiLiyan spray may reduce the hospitalization expenses for patients though it can not reduce the LHS,which shows it is more economical and applicable than Kangfuxim solution.6.Comparison of safety between the two groups.As there was only 1 patient with sore throat in the observation group and 2 patients in the control group within 24hours after operation,there was no significant difference in unplanned extubation rate between the two groups(P>0.05).Adverse drug reactions in the two groups were analyzed from the aspects of organ involvement.No skin and appendage reactions were found in the two groups.The number of patients with digestive system reactions in the observation group was significantly lower than that in the control group(6 vs 15,P<0.05),indicating that both drugs were safe while the side effects of XuanmaiLiyan spray was better than Kangfuxin solution in this aspect.7.Comparison of the total curative effect of the two drugs.The total curative effect of the observation group was 94.6%,and that of the control group was 75%,with significant difference(P<0.05).It shows that XuanmaiLiyan spray has a more definite clinical effect and is worthy of further clinical application.[Conclusion]1.Compared with Kangfuxin solution,XuanmaiLiyan spray can significantly relieve sore throat,oropharyngeal complications,dry throat and swallowing discomfort symptoms,while improving the quality of sleep for patients with NG tube intubation after endoscopic surgery.2.XuanmaiLiyan spray has definite clinical efficacy and safety with affordable price,which is worthy of clinical application. |
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