足三里穴位注射山莨菪碱对内镜袖状胃成形术患者术后恢复质量的影响  

Effect of anisodamine injection at the Zusanli acupoint on postoperative recovery quality of patients undergoing laparoscopic sleeve gastrectomy

作　　者：程建鑫 王萧晗 王蕊 盛婧祎 郭珊珊 刘天雅 王志萍 Cheng Jianxin;Wang Xiaohan;Wang Rui;Sheng Jingyi;Guo Shanshan;Liu Tianya;Wang Zhiping(Department of Anesthesiology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221002,China)

机构地区：[1]徐州医科大学附属医院麻醉科,徐州221002

出　　处：《国际麻醉学与复苏杂志》2024年第7期689-695,共7页International Journal of Anesthesiology and Resuscitation

基　　金：国家自然科学基金(82270059);江苏省自然科学基金(BK20221222);中国初级卫生保健基金会项目(YLGX-MZ-2022004)。

摘　　要：目的探讨足三里穴位注射山莨菪碱对内镜袖状胃成形术患者术后早期恢复质量的影响。方法选取择期行内镜袖状胃成形术的患者117例,按随机数字表法分为空白对照组(C组)、足三里穴位注射生理盐水组(S组)、足三里穴位注射山莨菪碱组(A组),每组39例。C组不做特殊干预,S组在两侧足三里穴位注射生理盐水,A组在两侧足三里穴位注射山莨菪碱氯化钠溶液。记录患者一般资料;记录患者术前1 d(D0)及术后1 d(D1)、术后3 d(D3)、术后7 d(D7)的40项恢复质量量表(QoR-40)评分(包含身体舒适度、情绪状态、自理能力、心理支持和疼痛感受5个维度);于麻醉诱导后(T_(0))和术后24 h(T_(1))收集患者静脉血,采用酶联免疫吸附测定(ELISA)法检测血浆白细胞介素-6(IL-6)、P物质(SP)和胃动素(MTL)水平;记录拔管时间、麻醉后监测治疗室(PACU)停留时间、不良事件(呃逆、呼吸抑制、头晕、尿潴留、术后出血等)发生情况、术后24 h数字分级评分法(NRS)疼痛评分、术后第1天地佐辛使用量、术后恶心呕吐(PONV)情况、术后首次下床活动时间、术后首次肛门排气时间和住院时长等术后指标。结果3组患者一般资料差异无统计学意义(均P>0.05)。与D0时比较,D1时A组患者QoR-40总分、情绪状态、自理能力、疼痛感受评分均下降(均P<0.05),S组和C组患者QoR-40总分、身体舒适度、情绪状态、自理能力、疼痛感受评分均下降(均P<0.05);D3时A组患者QoR-40总分、疼痛感受评分均下降(均P<0.05),S组和C组患者QoR-40总分、身体舒适度、疼痛感受评分均下降(均P<0.05);D7时S组和C组患者QoR-40总分均下降(均P<0.05),C组患者疼痛感受评分下降(P<0.05)。与C组比较,A组患者D1、D3时QoR-40总分、身体舒适度评分均增加(均P<0.05),D1、D3和D7时疼痛感受评分均增加(均P<0.05),S组患者D1时QoR-40总分增加(P<0.05);与S组比较,A组患者D1时QoR-40总分增加(P<0.05)。与ObjectiveTo investigate the effect of anisodamine injection at the Zusanli acupoint on the postoperative quality of early recovery in patients undergoing laparoscopic sleeve gastrectomy.MethodsA total of 117 patients who underwent elective laparoscopic sleeve gastrectomy were selected.According to the random number table method,they were divided into three groups(n=39):a blank control group(group C),a group with normal saline injection at the Zusanli acupoint(group S),and a group with scopolamine injection at the Zusanli acupoints(group A).Group C did not receive any special interventions,group S was injected with normal saline at each Zusanli acupoint on both sides,group A was injected with anisodamine sodium chloride solution at each Zusanli acupoint on both sides.Their general information were recorded;their 40-item Quality of Recovery Scale(QoR-40)scores(including five dimensions:physical comfort,emotional state,self-care,psychological support and pain perception)were recorded on preoperative day 1(D0)and postoperative day 1(D1),postoperative day 3(D3),and postoperative day 7(D7).After anesthesia induction(T_(0))and on postoperative 24 h(T_(1)),their venous blood samples were collected,the levels of plasma interleukin-6(IL-6),substance P(SP),and motilin(MTL)were measured by enzyme-linked immunosorbent assay(ELISA).The time to extubation,the length of post-anesthesia care unit(PACU)stay,the incidences of adverse events(hiccup,respiratory depression,dizziness,urinary retention,and postoperative bleeding),Numerical Rating Scale(NRS)score at postoperative 24 h,the consumption of analgesic dezocine on postoperative day 1,the incidence of postoperative nausea and vomiting(PONV),the time to first postoperative off-bed activity,the time to first postoperative anal exhaust,and the length of hospitalization stay were recorded.ResultsThere was no statistical difference in general information among the three groups(P>0.05).On D1,group A showed decreases in QoR-40 total score,emotional state,self-care ability,and pain per

关 键 词：足三里 穴位注射 山莨菪碱 内镜袖状胃成形术 术后恢复质量 

分 类 号：R614[医药卫生—麻醉学]