穴位注射辅助局麻下经皮椎间孔镜椎间盘髓核摘除术术中镇痛的临床探究  

Clinical Study on the Analgesia of Percutaneous Lumbar Intervertebral Discectomy after Acupoint Injection Assisted Local Anesthesia

作　　者：熊琼[1] 熊青媛 涂娟[1] 成新花[1] XIONG Qiong;XIONG Qingyuan;TU Juan;CHENG Xinhua(Operating Room,Nanchang Hospital of Integrated Traditional Chinese and Western Medicine(Nanchang Second Hospital),Jiangxi Province,Nanchang 333000,China)

机构地区：[1]南昌市中西医结合医院(南昌市第二医院)手术室

出　　处：《中国中医药现代远程教育》2019年第16期40-42,共3页Chinese Medicine Modern Distance Education of China

基　　金：江西省卫生计生委科技计划【No.20177028】

摘　　要：目的探讨穴位注射辅助局麻下经皮椎间孔镜椎间盘髓核摘除术术中镇痛的临床效果。方法选取2014年4月—2015年12月收治的具有手术指征并同意进行手术的腰椎间盘突出症患者100例,以随机原则分为对照组与观察组,每组50例。对照组采用局麻下经皮椎间孔镜椎间盘髓核摘除术常规手术护理配合进行护理,观察组在其基础上,遵医嘱在穴位注射东莨菪碱与生理盐水辅助术中镇痛;术中观察患者呼吸情况,术后采用视觉模拟评分法(VAS)对患者进行术中疼痛测试,并统计患者对麻醉的满意度。结果观察组出现呼吸不畅的患者1例,少于对照组的11例(P<0.05);且护理后的术中VAS评分为(2.1±1.3)分,明显低于对照组的(5.4±1.9)分(P<0.05)。结论穴位注射辅助局麻下经皮椎间孔镜椎间盘摘除术术中镇痛护理能够减少患者手术治疗过程中的痛苦,帮助患者树立手术顺利的信心,促进术后康复,提高了患者满意率,同时丰富了手术护理配合的中医护理内涵,具有较高的临床应用价值。Objective To investigate the clinical effect of acupoint injection in the treatment of analgesia with percutaneous transforaminal discectomy.Methods One hundred patients with lumbar disc herniation who had surgical indications and agreed to undergo surgery were enrolled in our hospital from April 2014 to December 2015.They were randomly divided into control group and observation group,with 50 cases in each group.The control group underwent routine operation and nursing with percutaneous transforaminal nucleus pulposus removal under local anesthesia.On the basis of the observation group,the analgesia was treated with acupuncture injection of scopolamine and saline in the acupuncture point;Respiratory condition,postoperative pain test was performed by visual analog scale(VAS),and the patient's satisfaction with anesthesia was counted.Results One patient with poor breathing in the observation group was less than 11 patients in the control group(P<0.05).The intraoperative VAS score after nursing in the observation group was(2.1±1.3),which was significantly lower than(5.4±1.9)of the control group(P<0.05).Conclusion Acupoint injection assisted percutaneous anastomosis with percutaneous transforaminal discectomy can reduce the pain during the surgical treatment,help patients establish the confidence of smooth operation,promote postoperative rehabilitation and improve patient satisfaction rate.At the same time,it enriches the connotation of traditional Chinese medicine nursing with surgical nursing,and has high clinical application value.

关 键 词：穴位注射 局麻 椎间盘髓核摘除术 术中镇痛 

分 类 号：R47[医药卫生—护理学]