不同时间电针干预对混合痔手术患者术后排尿功能的影响  

Effect of electroacupuncture at different time points on postoperative urination function in patients with mixed hemorrhoids surgery

作　　者：何玉海[1,2] 兰凯[2] 谢丹 黄杏贤[3] 卢昌碒[1] 李娟 沈峰岩[1] 黄增平 于海波[3] HE Yu-hai;LAN Kai;XIE Dan;HUANG Xing-xian;LU Chang-yin;LI Juan;SHEN Feng-yan;HUANG Zeng-ping;YU Hai-bo(Department of Anesthesia,Shenzhen TCM Hospital,Shenzhen 518033,Guangdong Province,China;Guangzhou University of CM,Guangzhou 510006,Guangdong Province;Department of Acupuncture and Moxibustion,Shenzhen TCM Hospital,Shenzhen 518033,Guangdong Province,China)

机构地区：[1]深圳市中医院麻醉科,广东深圳518033 [2]广州中医药大学,广东广州510006 [3]深圳市中医院针灸科,广东深圳518033

出　　处：《中国针灸》2023年第4期422-426,共5页Chinese Acupuncture & Moxibustion

基　　金：广东省中医药局科研项目:20201302;深圳市“三名工程”中国中医科学院刘保延首席研究员中国针灸临床评价方法创新项目:SZSM201612001。

摘　　要：目的:探讨术前、术中、术后电针干预对混合痔手术患者术后排尿功能的影响.方法:将240例腰麻下行混合痔手术患者随机分为术前电针预处理组(A组,60例,脱落9例)、术中电针组(B组,60例,脱落4例)、术后电针组(C组,60例,脱落6例)及未针刺组(D组,60例,脱落3例).A、B、C 3组患者分别在腰麻前30 min、腰麻后即刻以及手术结束后6 h于中髎、会阳行电针干预,疏密波,4 Hz/20 Hz,留针30 min;D组不予电针干预.于术后24 h观察各组患者术后排尿通畅感受评分,记录各组患者首次排尿时间、首次排尿量、首次排尿残余尿量,同时观察各组留置导尿情况、术后视觉模拟量表(VAS)评分、补救镇痛例数以及术后恶心呕吐情况.结果:A、B、C 3组患者术后排尿通畅感受评分优于D组(P<0.05);首次排尿时间早于D组(P<0.05).C组患者首次排尿时间早于A、B组(P<0.05);首次排尿量多于D组(P<0.05),首次排尿残余尿量少于D组(P<0.05).4组患者留置导尿、术后恶心呕吐情况比较,差异均无统计学意义(P>0.05).A、B、C 3组患者VAS评分低于D组(P<0.05),补救镇痛例数少于D组(P<0.05).结论:电针干预可促进混合痔手术患者术后排尿功能的恢复,缓解患者术后疼痛.术后早期电针干预更有利于排尿功能的恢复.Objective To observe the effect of preoperative,intraoperative and postoperative electroacupuncture(EA)intervention on postoperative urination function in patients with mixed hemorrhoid surgery.Methods A total of 240 patients with mixed hemorrhoid surgery under lumbar anesthesia were randomly divided into an EA preconditioning group(group A,60 cases,9 cases dropped off),an intraoperative EA group(group B,60 cases,4 cases dropped off),a postoperative EA group(group C,60 cases,6 cases dropped off),and a non-acupuncture group(group D,60 cases,3 cases dropped off).In the groups A,B and C,EA was exerted at Zhongliao(BL 33)and Huiyang(BL 35),with disperse-dense wave,4 Hz/20 Hz in frequency,and lasting 30 min,at 30 min before lumbar anesthesia,immediately after lumbar anesthesia and 6 h after surgery,respectively.No EA intervention was performed in the group D.The postoperative urination smoothness score in each group was observed 24 h after surgery.The first urination time,first urination volume,urine residual volume after first urination were recorded,and incidence of indwelling catheterization,postoperative visual analogue scale(VAS)score,number of remedial analgesia,and the incidence of postoperative nausea and vomiting were observed in each group.Results In the groups A,B and C,the postoperative urination smoothness scores were superior to the group D(P<0.05),and the time of first urination was earlier than the group D(P<0.05).In the group C,the time of first urination was earlier than the group A and the group B(P<0.05),the first urination volume was higher than the group D(P<0.05),and the urine residual volume after first urination was lower than the group D(P<0.05).There was no significant dfference in the incidence of indwelling catheterization and postoperative nausea and vomiting among the 4 groups(P>0.05).The VAS scores of the group A,B and C were lower than that in the group D(P<0.05),and the number of remedial analgesia cases was lower than that in the group D(P<0.05).Conclusion EA intervention could promo

关 键 词：混合痔 术后排尿困难 电针 干预时机 随机对照试验 

分 类 号：R246.2[医药卫生—针灸推拿学]