浮针对腔镜甲状腺术患者术后颈肩痛的临床疗效及局部组织氧的影响  

Clinical efficacy of Fu′s subcutaneous needling on postoperative neck and shoulder pain and local tissue oxygenation in patients undergoing endoscopic thyroid surgery

作　　者：何创[1] 闫雪静 许菲[3] 贺必梅[1] 张森森[1] 潘桂秋 洪庆雄[1] 

机构地区：[1]广东省中医院麻醉科 [2]广州市中西医结合医院甲乳科 [3]广东省中医院理疗科

出　　处：《广东医学》2025年第3期476-480,共5页Guangdong Medical Journal

基　　金：广州中医药大学华南针灸研究中心项目(2021KT1604)。

摘　　要：目的探讨浮针疗法对缓解经腔镜甲状腺手术患者术后颈肩部疼痛的临床疗效及对颈肩部组织氧的影响。方法选取2023年2月至2024年2月于广东省中医院择期行经乳晕入路或者经口腔前庭入路的腔镜甲状腺切除术的患者作为研究对象,将术后颈肩部疼痛评分≥3分的100例术后患者随机分为观察组和对照组,每组50例。应用近红外光谱局部组织氧监测技术比较不同两侧颈肩部的局部组织氧饱和度情况,观察组采用浮针治疗,选取的穴位为双侧肩井穴,时间治疗为30 min,留针6 h后拔针,对照组不予浮针治疗,比较两组患者不同时间点的局部组织氧饱和度和VAS评分。结果两组患者的双侧局部组织氧饱和度在手术后2~4 h和手术后24 h均有不同程度下降,观察组在手术后24 h的双侧局部组织氧饱和度明显高于对照组,差异有统计学意义(P<0.05)。两组患者在手术后2~4 h的VAS疼痛评分均明显升高,观察组为(4.27±0.13)分,对照组为(4.31±0.11)分,24 h后,观察组疼痛评分明显低于对照组[(1.22±0.61)分vs.(2.11±0.70)分],差异有统计学意义(P<0.05)。结论浮针治疗可以明显减轻腔镜甲状腺术后患者颈肩部疼痛,改善局部组织氧饱和度。Objective To investigate the clinical efficacy of Fu′s subcutaneous needling(FSN)on postoperative neck and shoulder pain in patients undergoing endoscopic thyroid surgery and its impact on local tissue oxygenation.Methods Patients undergoing elective endoscopic thyroidectomy via the trans-areolar or transoral vestibular approach at Guangdong Provincial Hospital of Traditional Chinese Medicine from February 2023 to February 2024 were enrolled.One hundred postoperative patients with neck and shoulder pain scores≥3 were randomly assigned to the observation group(n=50)or the control group(n=50).Near-infrared spectroscopy(NIRS)was used to monitor local tissue oxygen saturation(rSO_2)in the bilateral neck and shoulder areas.The observation group received FSN treatment at bilateral Jianjing(GB21)acupoints for 30 minutes,with needles retained for 6 hours before removal,while the control group did not receive FSN treatment.Changes in rSO_2 and visual analog scale(VAS)pain scores were compared between the two groups at different time points.Results Compared to preoperative levels,rSO_2 significantly decreased in both groups 2-4 hours and 24 hours after surgery(P<0.05).In obserevation group,rSO_2 significantly increased at 24 hours postoperatively compared to control group(P<0.05).VAS scores also significantly decreased at 24 hours postoperatively compared to 2-4 hours postoperatively in both groups,with the observation group showing significantly lower VAS scores than the control group(P<0.05).Conclusion Fu′s subcutaneous needling effectively alleviates postoperative neck and shoulder pain in patients undergoing endoscopic thyroid surgery and improves local tissue oxygen saturation.

关 键 词：浮针 甲状腺 颈肩痛 局部组织氧饱和度 

分 类 号：R246[医药卫生—针灸推拿学] R614[医药卫生—中医临床基础]