腕踝针针刺联合低剂量塞来昔布口服在全髋关节置换术围手术期镇痛的临床观察  

Clinical Study on Analgesia Effect of Wrist-Ankle Acupuncture Combined with Low Doses of Celecoxib Orally on Perioperative Period of Total Hip Arthroplasty

作　　者：李文龙[1] 李阳阳[1] 张海龙[1] 毛晓艳[1] 王会超[2] 刘又文[2] 

机构地区：[1]河南中医药大学,河南郑州450008 [2]河南省洛阳正骨医院河南省骨科医院,河南洛阳471002

出　　处：《中国中医急症》2017年第1期158-161,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：河南省研究生教育创新培养基地研究生创新项目(2015年度)

摘　　要：目的观察腕踝针针刺联合低剂量塞来昔布口服在全髋关节置换术(THA)围手术期镇痛的临床疗效。方法 73例单侧THA手术患者随机分为试验组(腕踝针联合低剂量塞来昔布组)35例和对照组(正常剂量塞来昔布组)38例两组。两组患者术前均进行疼痛知识宣教,术后均使用自控镇痛泵(PCA)镇痛48 h。试验组给予口服塞来昔布联合腕踝针针刺治疗;对照组仅给予口服塞来昔布,两组均持续至术后第4天。采用视觉模拟评分(VAS)评估两组患者术后疼痛程度,Harris评分评估患者髋关节功能,记录患者术后每12小时PCA使用剂量、术后48 h内总使用剂量及使用PCA期间不良反应发生情况。结果两组VAS评分在术后不同时间点VAS疼痛评分差异无统计学意义(均P>0.05)。两组术后各时间段(0~12 h、12~24 h、24~36 h、36~48 h)镇痛药物用量比较,差异无统计学意义(均P>0.05)。两组治疗前、术后2周及术后3个月髋关节Harris评分差别不大(均P>0.05)。两组术后48 h不良反应(恶心呕吐、尿潴留、眩晕嗜睡)比较,差异无统计学意义(P>0.05)。两组均未行盐酸哌替啶肌注补救。结论应用腕踝针针刺联合低剂量塞来昔布口服在THA围手术期镇痛,能减轻术后疼痛、减少术后镇痛药物及围手术期塞来昔布用量,进而加快关节功能恢复并减轻患者经济负担。Objective： To observe the clinical analgesia effect of wrist-ankle acupuncture combined with low doses of celeeoxib orally on perioperative period of total hip arthroplasty. Methods： Seventy-three patients treated with unilateral THA were randomly divided into experimental group （wrist-ankle acupuncture combined with low doses of celecoxib orally） and control group（normal dose of celecoxib orally）. There were thirty-five cases in experimental group and thirty-eight cases in control group. The patients in the 2 groups were treated with pain knowledge education before the operation. All patients received patient controlled analgesia pump （PCA） for 48 hours after surgery. Moreover,the patients in experimental group were given wrist ankle acupuncture combined with low doses of celecoxib orally and the patients in control group were given normal dose of celecoxib orally. All treatments continued to the fourth day after surgery. VAS was used to evaluate the degree of pain;Harris score was used to evaluate the function of hip joint. The dosage of liquids of PCA every 12 hours after surgery,the total dosage of liquids of PCA during 48 hours after surgery and adverse reaction of PCA pump in different time were recorded. Results： There was no statistical difference on VAS scores between the 2 groups at different time points after surgery （4^th,8^th, 12^th, 1^st,2^nd,3^rd d,4^th）（all P〉0.05）. There was no statistical difference on dosage of liquids between the 2 groups at different time points after the operation （0-12 h, 12-24 h,24-36 h,36-48 h） （all P〉 0.05）. There was no statistical difference on Harris hip scores between the 2 groups in general before the treatment,in 2 weeks after surgery and in 3 months after surgery （all P〉 0.05）. During the using of PCA,there was no significant difference between the 2 groups in 48 hours after surgery on nausea and vomiting,urinary retention, dizziness and drowsiness（P〉 0.05）. Both groups were not treated with pethidine hydrochloride

关 键 词：关节成形术 围手术期 腕踝针 环氧化酶-2抑制剂 疼痛 

分 类 号：R246.2[医药卫生—针灸推拿学]