经皮穴位电刺激复合喉罩全麻对环状混合痔切除术临床并发症的影响  

Effect of Transcutaneous Electrical Acupoint Stimulation Combined with Laryngeal Mask General Anesthesia on Clinical Complications of Milligan-Morgan Hemorrhoidectomy

作　　者：陈静[1] 吴芹萍 范锡义 唐太春[2] 宋曦[2] 霍兰[2] Chen Jing;Wu Qinping;Fan Xiyi;Tang Taichun;Song Xi;Huo Lan(Chengdu University of Traditional Chinese Medicine,Chengdu,610075,China;Teaching Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,610072,China)

机构地区：[1]成都中医药大学,四川成都610075 [2]成都中医药大学附属医院,四川成都610072

出　　处：《成都中医药大学学报》2022年第3期63-67,共5页Journal of Chengdu University of Traditional Chinese Medicine

基　　金：成都市卫计委重点项目(2015027);成都中医药大学一般项目(030029032);四川省卫健委重点项目(130398)。

摘　　要：目的:观察经皮穴位电刺激复合喉罩全麻在环状混合痔切除术临床并发症中的优越性。方法:选择择期行环状混合痔切除术患者100例,年龄18-65岁,美国麻醉医师协会(ASA)Ⅰ或Ⅱ级,按1∶1随机分为2组即经皮穴位电刺激复合喉罩全麻组(观察组)和单纯喉罩全麻组(对照组),每组各50例;观察组全麻诱导前30 min至术毕持续行经皮穴位电刺激,术后连续3 d间断行经皮穴位电刺激,刺激穴位选取双侧合谷、内关穴,两组患者术后均行静脉自控镇痛,监测2组患者术后4、8、12、24 h的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2));记录2组患者术后4、8、12、24、48、72 h疼痛视觉模拟量表评分(Visual Analogue Scale,VAS);记录2组患者术后安置尿管、大便困难例数。结果:观察组术后8 h、12 h平均动脉压(MAP)、心率(HR)较对照组稳定,差异具有统计学意义(P<0.05);观察组术后4 h、8 h VAS疼痛评分、术后尿潴留、大便困难的发生率均低于对照组,差异具有统计学意义(P<0.05)。结论:经皮穴位电刺激复合喉罩全麻可增强患者环状混合痔切除术镇痛效果,减少术后尿潴留及大便困难等临床并发症,并能提高术后舒适度和麻醉安全性。Objective:To observe the superiority of transcutaneous electrical acupoint stimulation combined with laryngeal mask general anesthesia on clinical complications of Milligan-Morgan Hemorrhoidectomy.Methods:100 patients with Milligan-Morgan Hemorrhoidectomy were selected,aged between 18 and 65,and met the American Society of Anesthesiologists(ASA)Grade Ⅰ or Ⅱ criteria.The 100 patients were randomly divided into two groups:combination transcutaneous electrical acupoint stimulation with laryngeal mask airway general anesthesia group(observation group)and simple laryngeal mask airway general anesthesia group(control group)(n=50).In the observation group,transcutaneous acupoint electrical stimulation was performed continuously from 30 minutes before induction of general anesthesia to the end of the operation,and intermittent transcutaneous acupoint electrical stimulation was performed continuously for 3 days after operation.Select Hegu and Neiguan acupoints to stimulate acupoints,patient-controlled intravenous analgesia was performed in both groups after the operation.Mean Arterial Pressure(MAP),Heart Rate(HR),and Blood Oxygen Saturation(SpO_(2))were monitored at 4,8,12 h,and 24 h after operation,recorded the number of patients with urinary retention and constipation in the two groups.Result:The MAP and HR at 8 h and 12 h after operation in the observation group were more stable than those in the control group(P<0.05),4,8 h after operation VAS score,the number of patients with postoperative urinary retention and constipation in the observation group were lower than the control group(P<0.05).Conclusion:Transcutaneous electrical acupoint stimulation combined with laryngeal mask general anesthesia can enhance the analgesic effect of Milligan-Morgan Hemorrhoidectomy,reduce postoperative urinary retention,constipation,and other clinical complications,it can also improve postoperative comfort degree and anesthetic safety.

关 键 词：环状混合痔切除术 经皮穴位电刺激 全身麻醉 并发症 

分 类 号：R246.2[医药卫生—针灸推拿学] R266[医药卫生—中医临床基础] R657.18[医药卫生—中医学]