腕踝针对膝骨关节炎患者初次表面置换PONV并发症的影响  

Effect of wrist-ankle acupuncture on complications of postoperative nausea and vomiting in patients with first time knee arthroplasty

作　　者：郭美容[1] 詹彩华[1] 杜桂菊 宋敏 李聪聪 卢超[1] GUO Meirong;ZHAN Caihua;DU Guiju;SONG Min;LI Congcong;LU Chao(Guangdong Provincial Second Hospital of Traditional Chinese Medicine,Guangzhou,Guangdong 100191,China;Fifth Affiliated Clinical Medical College,Guangzhou University of Traditional Chinese Medicine,Guangzhou,Guangdong 510095,China)

机构地区：[1]广东省第二中医院,广州100191 [2]广州中医药大学附属第五临床医学院,广东广州510095

出　　处：《现代医药卫生》2020年第5期660-662,667,共4页Journal of Modern Medicine & Health

基　　金：广东省中医药局名中医传承工作室建设项目(粤中医办函〔2017〕17号);广东省中医药局中医药强省科研项目(20183001)

摘　　要：目的探讨腕踝针减少膝关节表面置换术(TKA)患者的术后恶心呕吐(PONV)情况。方法将75例接受TKA治疗的患者随机分为观察组(40例)和对照组(35例)。所有患者均给予硬膜外麻醉,由同一主刀医生完成手术,使用同一公司假体,术后应用静脉给药式镇痛泵(PCIA),外用丁丙诺啡止痛,并静脉注射帕瑞昔布钠以急性止痛。术后48 h内评估PONV的总发生率、抗呕吐药物需求、疼痛程度评分。结果观察组术后48 h内术后需抗呕吐药的发生率明显低于对照组,差异有统计学意义(P=0.043);且两组PONV发生率、术前疼痛程度、术后疼痛程度均无显著差异(P=0.244、0.697、0.249)。结论腕踝针可降低采用多模式疼痛方案治疗的TKA患者48 h内PONV抗呕吐药物的使用需求。Objective To investigate the effect of wrist-ankle acupuncture for reducing postoperative nausea and vomiting(PONV)in the patients with total knee arthroplasty(TKA).Methods Seventy-five patients receiving TKA treatment were randomly divided into the observation group(n=40)and control group(n=35).All cases were given the epidural anesthesia and completed the operation by the same surgeon.The prosthesis made by the same corporation was used.The patient-controlled intravenous analgesia(PCIA)was applied after operation.The external use of buprenorphine was adopted for analgesia and intravenous injection of parecoxib sodium was used for acute analgesia.The total incidence rate of PONV,demand for anti-vomiting drugs and pain score were assessed within 48 h after operation.Results The incidence rate of requiring antiemetic drugs within 48 h after operation in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P=0.043),moreover the incidence rate of PONV,preoperative pain degree and postoperative pain degree in two groups had no statistically significant differences(P=0.244,0.697,0.249).Conclusion The wrist-ankle acupuncture can reduce the demand for PONV antiemetic drugs within 48 h in the patients with TKA adopting by multi-mode pain regimen.

关 键 词：腕踝针 膝关节表面置换术 多模式镇痛方案 术后恶心呕吐 

分 类 号：R619.9[医药卫生—外科学]