腕踝针对气管插管机械通气患者的镇痛效果  

Analgesic Effect of Wrist and Ankle Acupuncture in Patients with Mechanical Ventilation of Tracheal Intubation

作　　者：林兰[1] 郑娟[1] 黄梅英[1] 林艳萍[1] 梁晓燕 LIN Lan;ZHENG Juan;HUANG Meiying;LIN Yanping;LIANG Xiaoyan(Second People’s Hospital,Fujian University of Traditional Chinese Medicine,Fuzhou 350003,China;不详)

机构地区：[1]福建中医药大学附属第二人民医院,福建福州350003

出　　处：《中外医学研究》2021年第10期7-10,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：福建省中青年教师教育科研项目(JT180243)。

摘　　要：目的:探讨腕踝针对气管插管机械通气患者的镇痛效果。方法:选取2019年1月-2020年1月入住本院重症医学科气管插管机械通气的患者60例。随机分为对照组(30例)、试验组(30例)。对照组予以盐酸纳布啡加0.9%氯化钠注射液以微量泵持续泵入治疗,试验组在对照组基础上予以腕踝针治疗。对比两组干预前后重症监护室疼痛观察工具法(CPOT)评分、RASS评分、72 h镇痛药物总用量及气管插管时间、安全性。结果:干预后4、8、24、48、72 h两组CPOT评分较干预前均降低(P<0.05);干预后24、48、72 h试验组CPOT评分[(1.41±0.21)、(1.25±0.15)、(0.43±0.06)分]低于对照组[(2.03±0.28)、(1.86±0.18)、(1.15±0.13)分],差异有统计学意义(P<0.001)。干预后4、8、24、48、72 h两组RASS评分均较干预前降低(P<0.05),干预4、8 h后试验组RASS评分[(0.51±0.17)、(-0.32±0.20)分]低于对照组[(0.91±0.23)、(-0.12±0.09)分],差异有统计学意义(P<0.001),干预后24 h、48 h、72 h试验组RASS评分[(-0.11±0.05)、(-0.15±0.05)、(-0.13±0.04)分]高于对照组[(-1.15±0.12)、(-1.55±0.09)、(-1.58±0.09)分],差异有统计学意义(P<0.001)。试验组72 h镇痛药物总用量为(42.07±11.05)ml,少于对照组的(79.06±16.26)ml(P<0.001);气管插管时间为(51.78±13.07)h,短于对照组的(70.52±15.30)h(P<0.001)。两组非计划性拔管、恶心呕吐发生率比较差异无统计学意义(P>0.05)。结论:对气管插管机械通气患者采用腕踝针治疗,可增强患者镇痛效果,减少镇痛药物用量,达到较为适宜的镇静效果,缩短插管时间,且不增加不良反应发生风险,值得临床推广应用。Objective:To explore the analgesic effect of wrist and ankle on mechanically ventilated patients with tracheal intubation.Method:From January 2019 to January 2020,60 patients with mechanical ventilation for tracheal intubation who were admitted to the Department of critical care medicine in our hospital were randomly divided into the control group (30 cases) and the experimental group (30 cases).The control group was given Nalbuphine Hydrochloride plus 0.9% Sodium Chloride Injection by continuous micropump,and the experimental group was given wrist and ankle acupuncture on the basis of the control group.The critical-care pain observation tool (CPOT) score and RASS score,total amount of analgesic drugs for 72 h,time of tracheal intubation and safety of the two groups were compared before and after the intervention.Result:At 4,8,24,48,72 h after intervention,the CPOT scores of the two groups were lower than those before the intervention (P<0.05).The CPOT scores of the experimental group[(1.41±0.21),(1.25±0.15),(0.43±0.06) points]24,48,72 h after intervention were lower than those of the control group[(2.03±0.28),(1.86±0.18),(1.15±0.13) points],the differences were statistically significant (P<0.001).At 4,8,24,48,72 h after intervention,the RASS scores of the two groups were lower than those before the intervention (P<0.05),the RASS scores of the experimental group[(0.51±0.17),(-0.32±0.20) points]were lower than those of the control group[(0.91±0.23),(-0.12±0.09) points]after 4 and 8 h intervention (P<0.001);the RASS scores of the experimental group[(-0.11±0.05),(-0.15±0.05),(-0.13±0.04)]24,48,72 h after intervention were higher than those of the control group[(-1.15±0.12),(-1.55±0.09),(-1.58±0.09) points](P<0.001).The total amount of analgesic drugs for 72 h in the experimental group was (42.07±11.05) ml,which was significantly less than that of the control group (79.06±16.26) ml (P<0.001),and the tracheal intubation time was (51.78±13.07) h,which was significantly shorter than that of the contro

关 键 词：腕踝针 气管插管 机械通气 镇痛 

分 类 号：R459.7[医药卫生—急诊医学]