双侧内关穴注射甲氧氯普胺与静脉注射甲氧氯普胺对妇科宫腔镜手术患者恶心呕吐分级的影响  

Effect of Bilateral Metoclopramide Injection at Neiguan Point Versus In⁃travenous Metoclopramide on the Grading of Nausea and Vomiting in Pa⁃tients Undergoing Gynecological Hysteroscopy

作　　者：蒋书明 黄建玲 郭铭辉[1] 黄智华[1] 汪学美 李林华 何姗[1] JIANG Shuming;HUANG Jianing;GUO Minghui;HUANG Zhihua;WANG Xuemei;LI Linhua;HE Shan(Department of Anesthesiology,Nanping People´s Hospital,Nanping,Fujian Province,353000 China)

机构地区：[1]福建省南平市人民医院麻醉科,福建南平353000

出　　处：《中外医疗》2022年第31期18-22,共5页China & Foreign Medical Treatment

基　　金：福建中医药大学校管科研课题任务书(XB2020119)。

摘　　要：目的 研究双侧内关穴注射甲氧氯普胺与静脉注射甲氧氯普胺对妇科宫腔镜手术患者(postoperative nausea and vomiting, PONV)分级的影响。方法 随机选取2020年8月—2022年1月福建省南平市人民医院收治的200例行妇科宫腔镜手术患者为研究对象,随机分为A组与B组,各100例,A组患者术中行双侧内关穴注射甲氧氯普胺,B组患者术中行静脉注射甲氧氯普胺。对比两组患者手术情况、术中心率(HR)、术中收缩压(SBP)、术后苏醒时间、术后下床活动时间、术后恢复进食时间、术后PONV发生情况及其他不良反应发生情况。结果 两组患者的SBP与T_1点相比,T_2点均明显降低、T_3点均升高,与T_1点相比,T_2、T_3点两组患者的HR均明显降低,差异有统计学意义(P<0.05)。T_4点,A组患者的HR、SBP均明显低于B组,差异有统计学意义(P<0.05);A组患者术后恢复进食时间明显短于B组患者,差异有统计学意义(P<0.05);A组患者术后0.5、4、12、24 h的PONV发生情况均优于B组患者,差异有统计学意义(Z=2.130、2.230、2.650、2.990,P=0.033、0.026、0.008、0.003);两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 术中双侧内关穴注射甲氧氯普胺用于预防妇科宫腹腔镜手术PONV,效果优于静脉注射甲氧氯普胺,且不影响麻醉恢复,有较高的安全性。Objective To study the effect of metoclopramide injected bilaterally at the Neiguan point versus intrave⁃nous metoclopramide on the grading of nausea and vomiting(PONV)in patients undergoing gynecological hysteros⁃copy.Methods 200 patients undergoing gynecological hysteroscopy in Nanping People´s Hospital of Fujian Province from August 2020 to January 2022 were randomly selected as the study subjects,randomly divided into group A and group B,with 100 patients each.Group A received intraoperative methoclopramide at both Neiguan points and group B received intravenous methoclopramide.The operation status,intraoperative heart rate(HR),intraoperative systolic blood pressure(SBP),recovery time after operation,ambulation time after operation,recovery time after operation,PONV occurrence and other adverse reactions were compared between the two groups.Results Compared with T 1,SBP in the two groups was significantly decreased at T2 and increased at T3,HR in the two groups was significantly de⁃creased at T2 and T3,the difference was statistically significant(P<0.05).At T4,the HR and SBP of a group A were sig⁃nificantly lower than those of group B,the difference was statistically significant(P<0.05).The time to resume eating after operation in group A was significantly shorter than that in group B,and the difference was statistically significant(P<0.05).The incidence of PONV at 0.5,4,12 and 24 h after operation in group A was significantly higher than those in group B,the difference was statistically significant(Z=2.130,2.230,2.650,2.990,P=0.033,0.026,0.008,0.003).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Intraoperative injection of metoclopramide at the bilateral Neiguan points for the prevention of PONV in gynecological hysteroscopic surgery was superior to intravenous metoclopramide.And it does not affect the recovery from anesthesia and has a high safety.

关 键 词：甲氧氯普胺 双侧内关穴注射 静脉注射 宫腔镜手术 恶心呕吐分级 

分 类 号：R5[医药卫生—内科学]