电针足三里穴配合纳布啡对混合痔PPH术中腹痛的影响  

Effect of electroacupuncture at point Zusanli(ST36)plus naborphine on abdominal pain during PPH for mixed hemorrhoids

作　　者：卢跃 汉晓云 张晓宏 梅宁宁 LU Yue;HAN Xiaoyun;ZHANG Xiaohong;MEI Ningning(Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China)

机构地区：[1]石家庄市中医院,石家庄050000

出　　处：《上海针灸杂志》2023年第7期743-747,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河北中医药类科研计划项目(2021253)。

摘　　要：目的观察电针足三里穴配合纳布啡对混合痔吻合器痔上黏膜环切术(procedure for prolapse and hemorrhoids,PPH)术中腹痛的影响。方法将80例适用PPH的混合痔患者随机分为治疗组和对照组,每组40例。两组均在严格骶管麻醉下行标准PPH手术,对照组给予静脉滴注盐酸纳布啡注射液,治疗组在对照组基础上对足三里穴加用电针治疗。观察两组不同时间点各项生命体征[收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、心率(heart rate,HR)、血氧饱和度(oxygen saturation,SpO2)]及术中牵拉腹痛视觉模拟量表(visual analog scale,VAS)评分的变化情况,比较两组术中止痛疗效、手术时长、恢复时长及术中并发症发生率。结果两组击发吻合器即刻(T2)至抽离吻合器时刻(T5)时HR和SpO2均较同组麻醉后(T1)时显著降低(P<0.05)。治疗组T2~T5时HR、SpO2及牵拉腹痛VAS评分明显低于对照组,差异均具有统计学意义(P<0.05)。治疗组术中止痛总有效率和并发症发生率分别为92.5%和47.5%,对照组分别为70.0%和85.0%,两组比较差异具有统计学意义(P<0.05)。治疗组恢复时长明显短于对照组(P<0.05)。结论电针足三里穴配合纳布啡对预防和缓解混合痔PPH术中腹痛的疗效确切,可显著降低患者术中牵拉反应的发生率,维持术中生命体征的平稳,缩短术后恢复时间,提高患者满意度。Objective To observe the effect of electroacupuncture at point Zusanli(ST36)plus naborphine on abdominal pain during procedure for prolapse and hemorrhoids(PPH)for mixed hemorrhoids.Method Eighty patients with mixed hemorrhoids suitable for procedure for prolapse and hemorrhoids(PPH)were randomized to treatment and control groups,with 40 cases in each group.Both groups underwent standard PPH under strict sacral anesthesia.The control group received intravenous drips of naborphine hydrochloride injection and the treatment group,electroacupuncture at point Zusanli(ST36)additionally.Vital signs[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)and oxygen saturation(SpO2)]at different time points and the visual analog scale(VAS)score for intraoperative abdominal dragging pain were observed in the two groups.Intraoperative analgesic effects,surgical durations,recovery durations and intraoperative complication incidences were compared between the two groups.Result HR and SpO2 decreased significantly in the two groups from stapler firing(T2)to removal(T5)compared with after anesthesia(T1)(P<0.05).HR,SpO2 and the VAS score for abdominal dragging pain from T2 to T5 were significantly lower in the treatment group than in the control group with statistically significant differences(P<0.05).The total efficacy rate of intraoperative analgesia and the incidence of complications were 92.5%and 47.5%,respectively,in the treatment group and 70.0%and 85.0%,respectively,in the control group with statistically significant differences between the two groups(P<0.05).The duration of recovery was significantly shorter in the treatment group than in the control group(P<0.05).Conclusion Electroacupuncture at point Zusanli(ST36)plus naborphine has a definite preventing and relieving effect on abdominal pain during PPH for mixed hemorrhoids.It can markedly reduce intraoperative incidence of traction response,maintain intraoperative stable vital signs,shorten postoperative duration of recovery and improve satisfaction i

关 键 词：电针 痔 疼痛 术后 穴 足三里 针药并用 针刺麻醉 

分 类 号：R246.2[医药卫生—针灸推拿学]