颊针疗法在椎体骨折经皮椎体成形术中镇痛效果研究  

Analgesic effect of cheeks acupuncture therapy in percutaneous vertebroplasty for vertebral fractures

作　　者：张苗苗 王雪娟 张月明 董帅帅 ZHANG Miaomiao;WANG Xuejuan;ZHANG Yueming;DONG Shuaishuai(Department of Anesthesiology,Sunshine Union Hospital,Weifang,Shandong 261061,China;Department of Traditional Chinese Medicine,Sunshine Union Hospital,Weifang,Shandong 261061,China)

机构地区：[1]阳光融和医院麻醉科,山东潍坊261061 [2]阳光融和医院中医科,山东潍坊261061

出　　处：《手术电子杂志》2024年第3期43-47,共5页Electronic Journal of Medical Operations

基　　金：潍坊市卫生健康委员会中医药科研项目计划(WFZYY2022-4-061)

摘　　要：目的 探讨颊针在椎体骨折经皮椎体成形术中的应用效果。方法 收集阳光融和医院2021年6月—2023年12月期间择期行经皮椎体成形术的患者80例,男35例,女45例,年龄40~90岁,体质量指数(BMI)(18~28) kg/m^(2),美国麻醉医师协会(ASA)Ⅰ~Ⅲ级。采用随机数字表法将患者分为两组:对照组(N=40例)和颊针治疗干预组(N=40例)。颊针组术前30 min采用颊针治疗,施针后采用5 min间隔行针1次,手术开始留置针,直至手术结束。对照组行常规全身麻醉,不使用颊针疗法治疗,静脉给予舒芬太尼、咪达唑仑镇痛镇静。记录进入手术室的时间(T0)、椎体穿刺时(T1)、骨水泥灌注时(T2)、手术结束(T3)、术后6h (T4)、术后24h (T5)的血压、心率。于T0、T5时采集静脉血,检测皮质醇(Cor)、空腹血糖(FPG)和空腹胰岛素(FIN),记录围术期简易精神状态量表(MMES)、视觉模拟量表(VAS)评分、住院天数以及围术期恶心呕吐(PONV)发生情况。结果 T1、T2时颊针组与对照组相比MAP水平明显降低,心率(HR)明显减慢(P<0.05)。与T0时比较,对照组在T5时间节点Cor、空腹血糖浓度、空腹胰岛素浓度明显升高(P<0.05),颊针治疗组皮质醇、血糖浓度、空腹胰岛素浓度水平与对照组相比明显降低(P<0.05)。颊针治疗组与对照组相比术后恶心呕吐例数明显降低,VAS评分显著降低,住院天数与对照组无明显差异。结论 在经皮椎体成形术中运用颊针疗法,有助于缓解围术期患者的疼痛程度,降低发生应激反应的幅度,可以用于经皮椎体成形术手术中辅助镇痛的选择。Objective To explore the application effect of cheeks acupuncture therapy in percutaneous vertebroplasty for vertebral fractures.Methods 80 patients(35 males and 55 females,aged 40~90 years)who underwent selective percutaneous vertebroplasty were selected,with BMI 18~28 kg/m^(2),ASA I-III grade.The patients were divided into two groups using a random number table method:control group(N=40)and cheeks acupuncture therapy group(N=40).The cheeks acupuncture therapy group started using buccal acupuncture therapy 30 minutes before operation,then the acupuncture was administered every 5 minutes and was kept during the whole course of operation.The control group was not treated with cheeks acupuncture therapy,but received intravenous sufentanil and midazolam for pain relief and sedation.Blood pressure and heart rate were recorded at the time of entry into the operating room(T 0),vertebral puncture(T 1),bone cement infusion(T2),end of operation(T3),6 hours(T4)and 24 hours(T5)after surgery.Venous blood was collected at T0 and T5 to measure cortisol(Cor),fasting blood glucose(FPG),and fasting insulin(FIN).The Mini Mental State Examination(MMES),VAS scores,discharge days and postoperative nausea and vomiting(PONV)were recorded.Results At T1 and T2,the MAP and HR of the acupuncture group were significantly lower than the control group(P<0.05).Compared with T0,the control group had significant increases in Cor,FPG and FIN at T5(P<0.05).Compared with the control group,the Cor,fasting blood glucose concentration,and fasting insulin concentration of the acupuncture group were significantly reduced at T 5(P<0.05).The number of postoperative nausea and vomiting cases in the acupuncture group was significantly lower than the control group,and the VAS score was significantly reduced.There was no significant difference in the number of discharge days between the two groups.Conclusion The use of cheeks acupuncture therapy in percutaneous vertebroplasty can help alleviate intraoperative and postoperative pain,reduce stress response,and

关 键 词：颊针 经皮椎体成形术 镇痛 应激反应 

分 类 号：R47[医药卫生—护理学]