耳穴贴压对妇科腹腔镜术后恶心呕吐发生率及镇痛效果的影响  

Influence of auricular point sticking on incidence of nausea and vomiting and analgesia effect after gynecological laparoscopy

作　　者：张丽红[1] 曹春玲 李井柱[3] 陈美伦[1] 王明山[3] 代春阳 

机构地区：[1]青岛市市立医院科研科,山东青岛266011 [2]青岛市市北区医院 [3]青岛市市立医院麻醉科,山东青岛266011

出　　处：《中国针灸》2013年第4期339-341,共3页Chinese Acupuncture & Moxibustion

摘　　要：目的:观察耳穴贴压对妇科腹腔镜术后患者恶心呕吐发生率及镇痛效果的影响,为耳穴贴压的临床应用提供依据。方法:将120例全身麻醉下择期行妇科腹腔镜手术患者随机分为耳穴贴压组、安慰组,每组60例。耳穴贴压组取耳穴神门、胃和交感,行王不留行籽耳穴贴压,于术前及术毕回病房后1、5、9、23h进行按压治疗,每穴每次按压5min,双耳同时对称进行。安慰组取穴、粘贴胶布等与耳穴贴压组相同,但不进行王不留行籽粘贴及按压。分别观察术后24h内恶心及呕吐发生率、托烷司琼使用率、吗啡使用率,术后2、6、10、24h的疼痛视觉模拟量表(VAS)评分及其他不良反应。结果:与安慰组比较,耳穴贴压组术后24h恶心及呕吐发生率[31.7%(19/60)、16.7%(10/60)vs 58.3%(35/60)、35.0%(21/60)]、托烷司琼使用率[21.7%(13/60)vs 48.3%(29/60)]、吗啡使用率[18.3%(11/60)vs 38.3%(23/60)],各时间点疼痛VAS评分均降低(均P<0.05),未发现其他不良反应。结论:耳穴贴压可显著降低妇科腹腔镜手术患者术后恶心呕吐发生率,并具有确切的镇痛效果。Objective To observe the influence of auricular point sticking on incidence of nausea and vomiting and analgesia effect after gynecological laparoscopy, and provide evidence for clinical application of auricular point sticking. Methods One hundred and twenty cases of selective gynecological laparoscopy under general anesthesia were randomly divided into an auricular point sticking group and a placebo group, 60 cases in each group. In the auricular point sticking group, the auricular point sticking with vaccaria seeds was applied at Shenmen （TF 4）, Wei （CO 4） and Jiaogan （AH 6a） before the operation and 1, 5, 9, 23 h after the operation, which were pressed 5 min each point each time. The two ears were proceeded at the same time. In the placebo group, the same point selection, sticking paste was used as the auricular point sticking group, but no sticking or pressing with vaccaria seeds was adopted. The incidence of nausea and vomiting, the usage rate of tropisetron and morphine within 24 hours of the operation, as well as the score of visual analogue scale （VAS） and other adverse reactions at 2, 6, 10, 24 h after the operation were observed respectively. Results Compared with the placebo group, the incidence of nausea and vomiting [31.7%（19/60）, 16.7%（10/60） vs 58.3%（35/60）, 35.0%（21/60）], the usage rate of tro- pisetron [＇-21.7%（13/60） vs 48.3%（29/60） and morphine [-18.3%（11/60） vs 38.3%（23/60）], the VAS scores at all different time points in the auricular point sticking group were all decreased （all P〈0.05）, and no adverse reaction was observed. Conclusion The auricular point sticking could significantly decrease the incidence of nausea and vomiting in patients of gynecological laparoscopy and has positive analgesic effect.

关 键 词：术后恶心呕吐 镇痛效果 耳穴贴压 妇科手术 

分 类 号：R246.3[医药卫生—针灸推拿学]