自控经皮电刺激耳神门穴对剖宫产术恶心及呕吐发生率的影响  

Effects on Nausea and Vomiting with Patient-controlled Transcutaneous Electrical Stimulation of Auricular Shenmen Point in Cesarean Section

作　　者：李井柱[1] 刘延莉[1] 马福国[1] 王明山[1] 时飞[1] 毕燕琳[1] 

机构地区：[1]青岛大学医学院附属青岛市市立医院,山东青岛266071

出　　处：《针灸临床杂志》2012年第3期1-4,共4页Journal of Clinical Acupuncture and Moxibustion

摘　　要：目的:探讨自控经皮电刺激耳神门穴对剖宫产术不同时间段恶心及呕吐发生率的影响。方法:240例择期剖宫产产妇,随机分为3组:自控经皮耳穴电刺激耳神门穴组(A组,n=80)、自控经皮电刺激耳眼点穴组(B组,n=80)与对照组(B组,n=80)。A组产妇入手术室后行自控耳穴电刺激,取神门穴,频率为1.5 Hz,强度由产妇自己掌握,刺激30 min后行腰～硬联合麻醉,术中持续刺激至术后2 h;B组取耳眼点穴,刺激方法与A组相同;C组夹穴连线等与A组相同,只是不进行电刺激。观察时间段:麻醉开始至胎儿剖出(T1)、胎儿剖出至子宫缝合完毕(T2)、探查腹腔至缝合皮肤切口(T3)、硬膜外腔给予吗啡至术后2 h(T4)。观察项目:①各时间段恶心及呕吐发生率、低血压、低心率发生率;②术中胃复安、缩宫素、麻黄碱、阿托品使用率;③新生儿Apgar评分及术中出血量。结果:A组较B组及C组,在T3、T4时间段的恶心及呕吐发生率降低(P<0.05),在T1、T2时间段3组无差异(P>0.05);A组较B组及C组胃复安使用率降低(P<0.05);3组低血压低心率发生率、缩宫素、麻黄碱、阿托品使用率、术中出血量及新生儿Apgar评分无差异(P>0.05)。结论:自控经皮电刺激耳神门穴明显降低剖宫产术中探查腹腔后与硬膜外使用吗啡后恶心及呕吐的发生率,但对麻醉开始至胎儿剖出时间段恶心及呕吐发生率无影响。Objective：To investigate the effects on nausea and vomiting with patient-controlled transcutaneous electrical stimulation of auricular Shenmen point in different timing of cesarean section.Methods：A randomized controlled clinical trail was conducted on 240 singleton primiparas undergoing elective cesarean section.The women were randomly divided into three groups： patient-controlled transcutaneous electrical stimulation with auricular Shenmen point group（group A,n=80）;patient-controlled transcutaneous electrical stimulation with auricular eye point group（group B,n=80） and control group（group C,n=80）.Women of group A were received patient-controlled transcutaneous electrical stimulation with auricular Shenmen point into the operating room（frequency 1.5 Hz）.The strength was controlled by them.Stimulation for 30 minutes before the epidural puncture,continued to stimulate after the end of surgery for two hours;Women of group B were received stimulation of auricular eye point as group A;Women of group C were received pressurization and connected line was the same as group A,but without electrical stimulation.Observation timing：（1）from onset of anesthesia to removal of the fetus（T1）;（2）from removal of the fetus to the uterine suture which was completed（T2）;（3）from abdominal exploration to the skin incision suture（T3）;（4）from epidural morphine that was given to the end of surgery（T4） for two hours.Observation indexes：（1） the rate of nausea and vomiting,hypotension and lower heart rate;（2） the rate of metoclopramide,oxytocin,atropine and ephedrine;（3） the volume of blood loss and neonatal Apgar score.Results：Compared with group B and group C,the rate of nausea and vomiting was lower in group A（P0.05） at the time of T3 and T4,but no significant difference（P0.05）at the time of T1 and T2;the rate of metoclopramide was decreased in group A（P0.05）.The rate of oxytocin,atropine and ephedrine,the volume of blood loss and the neonatal Apgar score

关 键 词：针刺 耳 神门穴 电刺激疗法 剖宫产术 手术后恶心呕吐 

分 类 号：R246.3[医药卫生—针灸推拿学]