耳穴贴压辅助全麻对妇科腹腔镜术后恶心呕吐发生率及镇痛效果影响的临床研究  

Clinical Study of Auricular Point Sticking Assisted Anesthesia on Incidence of Nausea and Vomiting and Analgesia Effect after Gynecological Laparoscopy

作　　者：陶涛[1] 陈婷[1] 杨爱明[1] 郑辉[1] 尉明洋[1] 金海燕[1] 郭小文[1] 

机构地区：[1]浙江中医药大学附属第一医院,杭州310006

出　　处：《浙江中医药大学学报》2016年第8期632-635,共4页Journal of Zhejiang Chinese Medical University

基　　金：浙江省中医药管理局基金资助项目(2015ZA077)~~

摘　　要：[目的]观察耳穴贴压辅助全麻对妇科腹腔镜术后恶心呕吐发生率及镇痛效果的影响,为耳穴贴压的围手术期应用提供依据。[方法]将60例择期全麻下行妇科腹腔镜手术患者随机分为耳穴贴压组、安慰治疗组,每组30例。耳穴贴压组取双耳穴神门、胃、贲门、交感,皮质下,于麻醉开始前30min、术毕清醒、术后2h、6h、24h给以耳穴贴压,安慰治疗组在相应穴位上黏贴外观相同的胶布,分别记录术后24h恶心呕吐程度视觉模拟量表评分及恶心呕吐发生率、胃复安使用率,记录术毕清醒、术后2h、6h、24h、48h的疼痛视觉模拟量表评分及静脉自控镇痛泵的按压次数和患者满意度。[结果]耳穴贴压组患者术后恶心呕吐评分、发生率及胃复安使用率均低于安慰治疗组,差异均有统计学意义(P<0.05),各时间点疼痛评分及镇痛泵按压次数均低于安慰组,差异均有统计学意义(P<0.05)。[结论]耳穴贴压辅助全麻妇科腹腔镜术可以显著减低术后患者恶心呕吐发生率、缓解疼痛、减少镇痛药物使用量及提高患者满意度,值得临床推广。[Objective]To observe the influence of auricular point sticking assisted anesthesia on incidence of nausea and vomiting and analgesia effect after gynecological laparoscopy, and provide evidence for peri-operative application of auricular point sticking. [Methods]Forty patients of selective gynecological laparoscopy under general anesthesia were randomly divided into auricular point sticking group and placebo group, with each group 20 patients. For auricular point sticking group, the auricular point sticking with vaccaria seeds was applied at Shenmen Wei Benmen Jiaogan and Pizhixia bilaterally 30 min before anesthesia. Anesthesia awake and 2, 6, 24h after operation, pressed lmin each point each time. For the placebo group, stick the same paste as auricular point sticking group at the corresponding points. The pain visual analogue scale（VAS） scores at anesthesia awake and 2,6,24h after operation, pressing frequency of patient controlled intravenous analgesia（PCIA）, the degree of nausea and vomiting visual analog scale scores 24h after operation, incidence of postoperative nausea and vomitiug（PONV）, usage of metoclopramide and degree of satisfaction were recorded respectively.[Resuhs]The VAS scores at all different time points, frequency of PCIA pressing, the degree of nausea and vomiting visual analog scale（NVAS） scores 24h after operation, incidence of PONV, usage of metoclopramide and degree of satisfaction in auricular point sticking group were all deceased compared with placebo group（P〈 0.05）. [Conclusion]Auricular point sticking assisted anesthesia could significantly decrease the incidence of PONV, usage of analgesics, greatly relieve postoperative pain and improve patient satisfaction in patients of gynecological laparoseopy, worth of clinical promotion.

关 键 词：恶心呕吐 腹腔镜 术后 镇痛 耳穴贴压 妇科 

分 类 号：R245.9[医药卫生—针灸推拿学]