针刺预防肛肠术后尿潴留的疗效观察  

Observation on the therapeutic effect of acupuncture on preventing urinary retention after anorectal surgery

作　　者：于婧辉[1] 周辉 王嘉宜 Yu Jinghui;Zhou Hui;Wang Jiayi(Department of Traditional Chinese Medicine,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,Ningxia Hui Autonomous Region,China;Department of General,Hexi Town Central Health Center,Wuzhong 751300,Ningxia Hui Autonomous Region,China)

机构地区：[1]宁夏回族自治区人民医院中医科,宁夏回族自治区银川750002 [2]河西镇中心卫生院全科,宁夏回族自治区吴忠751300

出　　处：《中国中西医结合急救杂志》2023年第3期368-371,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：目的观察针刺对肛肠术后尿潴留的预防作用。方法选择2021年8月至2022年8月就诊于宁夏回族自治区人民医院中医科收治的120例肛肠疾病行手术治疗患者作为研究对象。根据发生术后尿潴留前干预措施不同将患者分为对照组及针刺组,每组60例。对照组给予常规干预措施促进术后排尿;针刺组在对照组基础上,于术后4 h给予普通针刺中极、三阴交、阴陵泉、膀胱俞等穴位,留针时间视其针感而定,约10~15 min;若经以上治疗无效则肌内注射(肌注)新斯的明,仍无效即给予导尿。比较两组患者尿潴留发生情况、新斯的明使用率、导尿率,以及患者首次排尿时间、小腹症状评分、排尿状况评分和总体满意度的差异。结果与对照组比较,针刺组尿潴留发生率、新斯的明使用率及留置导尿率均明显降低〔尿潴留发生率:10.00%(6/60)比43.33%(26/60),新斯的明使用率:10.00%(6/60)比43.33%%(26/60),留置导尿率:6.67%(4/60)比40.0%(24/60),均P<0.05〕,首次排尿时间明显缩短(h:7.38±0.69比6.44±0.71,P<0.05),小腹症状和排尿状况评分均明显降低〔小腹症状评分(分):1.82±1.31比2.48±1.56,排尿状况评分(分):1.53±1.37比2.75±2.19,均P<0.05〕,患者总体满意度明显升高〔93.33%(56/60)比78.33%(47/60),P<0.05〕;两组均未出现不良反应及复发情况。结论在肛肠术后尿潴留发生之前给予针刺治疗,可有效降低术后尿潴留发生率,促进患者术后排尿,改善临床症状,效果肯定,值得进一步研究。Objective To observe the preventive effect of acupuncture on urinary retention after anorectal surgery.Methods From August 2021 to August 2022,120 patients with anorectal diseases who received suigical treatment in Department of Traditional Chinese Medicine,People's Hospital of Ningxia Hui Autonomous Region were selected as the research objects.According to the different intervention measures before postoperative urinary retention,they were divided into control group and acupuncture group with 60 cases in each group.The control group was given routine intervention measures to promote postoperative urination;Based on the treatment of control group,the acupuncture group was given ordinary acupuncture at Zhongji,Sanyinjiao,Yinlingquan,Pangguangshu and other points 4 hours after operation,and the needle retention time was about 10-15 minutes depending on the acupuncture sensation.If it is ineffective,Neostigmine was injected intramuscularly,and if it is still ineffective,the urinary catheterization was indwelled.The difference of occurence of urinary retention,usage rate of neostigmine,urethral catheterization rate,first urination time,abdominal symptom score,urination status score,and overall satisfaction were compared between the two groups.Results Compared with the control group,the incidence of urinary retention,the injection rate of Neostigmine,and the indwelling catheterization rate in the acupuncture group were significantly reduced[the incidence of urinary retention:10.00%(6/60)vs.43.33%(26/60),the usage rate of Neostigmine:10.00%(6/60)vs.43.33%(26/60),the indwelling rate of catheter:6.67%(4/60)vs.40.0%(24/60),all P<0.05],the first micturition time was significantly shortened(hours:7.38±0.69 vs.6.44±0.71,P<0.05),and the scores of abdominal symptoms and micturition status were significantly reduced(abdominal symptoms score:1.82±1.31 vs.2.48±1.56,micturition status score:1.53±1.37 vs.2.75±2.19,both P<0.05),the overall satisfaction increased significantly[93.33%(56/60)vs.78.33%(47/60),P<0.05].There were no

关 键 词：针刺 尿潴留 肛肠手术 预防 

分 类 号：R737.9[医药卫生—肿瘤]