电针复合阴部神经阻滞在肛瘘手术中应用的临床研究  

Clinical study of electroacupuncture combined with pudendal nerve block in anal fistula operation

作　　者：宋伟[1] 严君君 薛慧[1] 李兴[1] 唐炜[1] SONG Wei;YAN Junjun;XUE Hui;LI Xing;TANG Wei(Department of Anesthesiology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院麻醉科,上海201203

出　　处：《上海中医药大学学报》2022年第S01期96-99,共4页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81603700,81973652)

摘　　要：目的:观察电针复合阴部神经阻滞在肛瘘手术中应用的临床疗效。方法:纳入120例接受肛瘘手术患者作为研究对象,随机分为试验组(电针八髎穴复合阴部神经阻滞)与对照组(脊麻),每组60例。比较两组患者术前术中平均动脉压(MAP)和心率(HR)变化、手术操作时间、术后第一次疼痛的时间、术后各时段的疼痛分级以及术后并发症情况,同时进行安全性评价。结果:①试验组术前术中平均动脉压和心率均没有显著性差异(P>0.05),对照组术中平均动脉压和心率比术前均降低(P<0.05)。②两组手术时间无明显差异(P>0.05),试验组术后第一次疼痛的发生时间相比对照组明显延长(P<0.05)。③术后6 h、12 h、24 h,试验组患者疼痛程度比对照组低。④试验组术后尿潴留及恶心呕吐发生率比对照组明显减少。结论:电针八髎穴联合阴部神经阻滞的麻醉方式,可满足手术所需的镇痛和肛门松弛需求,不引起循环波动,并且术后可以维持更长的镇痛时间,保留更优的运动功能,促进患者快速康复(ERAS)。Objective:To observe the clinical efficacy of electroacupuncture combined with pudendal nerve block in anal fistula operation.Methods:One hundred and twenty patients undergoing anal fistula operation were taken as subjects,and were randomly divided into the experimental group(electroacupuncture at Baliao acupoint combined with pudendal nerve block)and the control group(spinal anesthesia),60 cases in each group.The changes of mean arterial pressure(MAP)and heart rate(HR)before and after operation,the time of operation,the time of the first postoperative pain,the grade of postoperative pain and the postoperative complications were compared between the two groups,and the safety was evaluated at the same time.Results:①There was no significant difference in preoperative and intraoperative mean arterial pressure and heart rate in the experimental group(P>0.05),and the intraoperative mean arterial pressure and heart rate in the control group were lower than those before operation(P<0.05).②There was no significant difference in operation time between the two groups(P>0.05).The occurrence time of the first postoperative pain in the experimental group was significantly prolonged compared with that in the control group(P<0.05).③At 6 h,12 h and 24 h after operation,the degree of pain in the experimental group was lower than that in the control group.④The incidence rates of postoperative urinary retention and nausea and vomiting in the experimental group were significantly lower than those in the control group.Conclusion:The anesthetic method of electroacupuncture at Baliao acupoint combined with pudendal nerve block can meet the needs of analgesia and anal relaxation required by operation,with no circulatory fluctuation,but longer analgesia time and better motor function,which could promote the enhanced recovery after surgery(ERAS).

关 键 词：电针 八髎穴 阴部神经阻滞 肛瘘 肛肠手术 麻醉 脊麻 

分 类 号：R614[医药卫生—麻醉学]