| 摘要: |
| 目的:探讨腕踝针治疗腹腔镜下胆囊切除术(LC)后疼痛的临床效果。方法:选择2019 年7 月—2020 年7 月在我院接受诊治的LC 患者90 例，按照随机数字表法分为A 组、B 组和C 组，各30 例。A 组在麻醉诱导前不采用任何治疗方法，手术结束后使用静脉自控镇痛泵；B 组在麻醉诱导前行耳穴压豆疗法，手术结束后使用静脉自控镇痛泵；C 组在麻醉诱导前行腕踝针治疗，手术结束后使用静脉自控镇痛泵。比较三组患者术后不同时间点镇痛、镇静评分，术后有效按压次数、总用量以及不良反应发生率。结果:术后12 h、24 h、48 h 时，B 组患者疼痛数字评分法(NRS)评分均明显低于A 组患者(P <0.05)，C 组患者NRS 评分均明显低于A、B 组患者(P <0.05)。术后12 h、24 h、48 h 时，B 组患者镇静评分均明显高于A 组患者(P <0.05)，C 组患者镇静评分均明显高于A、B 组患者(P <0.05)。B 组患者经静脉自控镇痛(PCIA)用量和有效按压次数均明显低于A 组患者(P <0.05)，C 组患者PCIA 用量和有效按压次数均明显低于A、B 组患者(P <0.05)。B组患者术后不良反应总发生率明显低于A 组患者(P <0.05)，C 组患者术后不良反应总发生率明显低于A、B 组患者(P <0.05)。结论:腕踝针联合静脉自控镇痛泵能够明显缓解LC 患者术后疼痛，提高镇静效果，并可有效减少静脉镇痛药物的使用量，降低术后不良反应的发生率。 |
| 关键词: 腕踝针 静脉自控镇痛泵 腹腔镜下胆囊切除术 术后疼痛 耳穴压豆疗法 |
| DOI：10.3969/j.issn.1007-6948.2021.06.018 |
| 投稿时间：2021-02-23 |
| 基金项目:新昌县科技计划项目(JFZC1913) |
|
| Clinical Effect of Wrist-ankle Acupuncture on Postoperative Pain after Laparoscopic Cholecystectomy |
| WANG Mei-ping,ZHANG Ke-jun |
| Department of Internal Medicine and Hepatobiliary Surgery, Xinchang County Hospital of Traditional Chinese Medicine, Shaoxing, Zhejiang (312500), China |
| Abstract: |
| Objective To investigate the clinical effect of wrist-ankle acupuncture combined with veincontrolled analgesic pump in the treatment of pain after laparoscopic cholecystectomy (LC). Methods 90 patients with LC who were treated in our hospital from July 2019 to July 2020 were selected and divided into group A, group B and group C according to the random number table method, with 30 cases each. Group A did not use any treatment before the induction of anesthesia and the intravenous self-controlled analgesic pump was used after the operation. Group B received auricular acupressure therapy before the anesthesia induction and the intravenous automatic analgesic pump was used after the operation. Group C was treated with wrist and ankle acupuncture before induction of anesthesia and the intravenous automatic analgesic pump was used after the operation. The analgesia and sedation scores of patients in three groups after operation at different time points,the number of effective compressions after operation, the total dosage and the incidence of adverse reactions were compared. Results Numerical rating scale (NRS) score of group B was significantly lower than that of group A at 12 h, 24 h and 48 h (P <0.05), and the NRS score of group C was significantly lower than that of group A and B (P <0.05). The sedation score of group B was significantly higher than that of group A at 12 h, 24 h and 48 h (P <0.05), and the sedation score of group C was significantly higher than that of group A and B (P <0.05). The amount of PCIA and the number of effective compressions in group B were significantly lower than those in group A (P <0.05). The amount of PCIA and the number of effective compressions in group C were significantly lower than those in groups A and B (P <0.05). The total incidence of postoperative adverse reactions in group B was significantly lower than that in group A (P <0.05), and the total incidence of postoperative adverse reactions in group C was signi.cantly lower than that in group A and B (P<0.05). Conclusion The treatment of wrist-ankle acupuncture combined with vein-controlled analgesic pump can significantly relieve postoperative pain in LC patients, improve the sedative effect as well as effectively reduce the use of intravenous analgesic drugs and the incidence of postoperative adverse reactions. |
| Key words: Wrist and ankle needles vein-controlled analgesic pump laparoscopic cholecystectomy postoperative pain auricular acupressure therapy |
