耳穴揿针对腹腔镜胆囊切除术后胃肠道反应的干预效果  

Intervention effect of auricular point thumbtack needle for gastrointestinal reactions after laparoscopic cholecystectomy

作　　者：王丹[1] 吴军[2] WANG Dan;WU Jun(Jiamusi University,Hegang,Heilongjiang 154000;Department of Anesthesiology,Heilongjiang Provincial Hospital,Harbin,Heilongjiang 150036)

机构地区：[1]佳木斯大学,黑龙江鹤岗154000 [2]黑龙江省医院麻醉科,黑龙江哈尔滨150036

出　　处：《河北中医》2023年第6期1016-1020,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的 观察耳穴揿针对腹腔镜胆囊切除术(LC)后胃肠道反应的干预效果。方法 将80例行LC患者按照随机数字表法分为2组,治疗组40例在麻醉前30 min应用耳穴揿针治疗,对照组40例在双侧对应耳穴穴位上贴相同胶布但不予耳穴揿针治疗,2组均治疗24 h。比较2组术前、术后24 h胃肠激素血浆胃泌素(GAS)、胃动素(MTL)、血管活性肠肽(VIP)水平变化;比较2组术后胃肠功能恢复情况;比较2组术后24 h内术后恶心呕吐(PONV)发生情况;比较2组术后24 h腹胀、腹痛严重程度;比较2组术前、术后24 h血浆神经递质5-羟色胺(5-HT)、P物质(SP)水平变化。结果 2组术后24 h GAS、MTL水平均较本组术前降低(P<0.05),VIP水平较本组术前升高(P<0.05);术后24 h治疗组GAS、MTL均高于对照组(P<0.05),VIP水平低于对照组(P<0.05)。治疗组术后肠鸣音恢复时间、首次排气时间、首次排便时间、首次进食时间及首次下床活动时间均较对照组提前(P<0.05)。2组术后24 h内PONV发生情况比较差异有统计学意义(P<0.05)。2组术后24 h腹胀、腹痛严重程度比较差异均有统计学意义(P<0.05)。2组术后24 h 5-HT水平较本组术前降低(P<0.05), SP水平较本组术前增加(P<0.05);术后24 h治疗组5-HT、SP水平均低于对照组(P<0.05)。结论 耳穴揿针治疗有助于预防LC患者术后胃肠道反应,调节胃肠激素水平,促进胃肠功能恢复。Objective To investigate the intervention effect of auricular point thumbtack needle for gastrointestinal reactions after laparoscopic cholecystectomy(LC).Methods Eighty patients who underwent LC were randomly assigned to the treatment group(n=40)and the control group(n=40),in which they were treated with auricular point thumbtack needle and adhesive tape at corresponding bilateral auricular acupoints,respectively.Treated for 24 hours,the aim was to compare gastrin(GAS),motilin(MTL),vasoactive intestinal polypeptide(VIP),hydroxytryptamine(5-HT),substance p(SP)preoperatively and at 24 hours postoperatively;postoperative gastrointestinal function recovery;postoperative nausea and vomiting(PONV),abdominal distension,abdominal pain severity at 24 hours postoperatively.Results At 24 hours postoperatively,reduced GAS and MTL and elevated VIP were found in groups(all P<0.05),higher GAS and MTL,and lower VIP were detected in the treatment group than those in the control group(all P<0.05).The postoperative bowel sounds recovery time,first exhaust time,first defecation time,first feeding time,first out-of-bed activity time in the treatment group were shorter than those in the control group(P<0.05).The difference was statistically significant in the PONV,abdominal distension and abdominal pain severity at 24 hours postoperatively between groups(all P<0.05).At 24 hours postoperatively,5-HT in groups was decreased(P<0.05),while SP was increased(P<0.05),5-HT and SP were decreased in the treatment group compared with the control group(P<0.05).Conclusion For patients who underwent LC,auricular point thumbtack needle is beneficial to prevent postoperative gastrointestinal reaction,regulate gastrointestinal hormone level and promote gastrointestinal function recovery.

关 键 词：胆囊切除术 腹腔镜检查 针刺疗法 穴位 耳针 

分 类 号：R605[医药卫生—外科学] R245.31[医药卫生—临床医学]