颊针疗法对改善子宫全切术后应激及胃肠反应的应用研究  

Application of buccal acupuncture therapy to improve stress and gastrointestinal reaction after total hysterectomy

作　　者：马志敏 邢凤娟 MA Zhi-min;XING Feng-juan

机构地区：[1]开封市妇产医院麻醉科,河南开封475000

出　　处：《中国疗养医学》2025年第4期23-27,共5页Chinese Journal of Convalescent Medicine

基　　金：河南省开封市科技发展计划项目(2203116)。

摘　　要：目的 观察颊针疗法对改善子宫全切术患者术后应激反应及胃肠反应的应用价值。方法 本研究为前瞻性研究,经双盲法抽取开封市妇产医院2022年1月至2024年2月收治的100例行子宫全切术患者为研究对象,应用电脑随机分组法生成随机序列,并进行分配隐藏后,将入组患者分别列为常规组(50例)和颊针组(50例),常规组予以常规全身麻醉,颊针组采用颊针疗法辅助全身麻醉,比较两组患者围术期血流动力学、围术期疼痛情况、术后应激指标及胃肠不良反应发生情况。结果 在不同麻醉方案下,颊针组诱导后5 min(T1)心率(HR)及平均动脉压(MAP)与常规组差异无统计学意义(P>0.05);颊针组插管时(T2)、术毕时(T3)的HR分别为(77.69±10.24)次/min、(75.33±10.21)次/min,均低于常规组(83.23±10.46)次/min、(80.44±10.27)次/min,MAP分别为(110.25±20.43)mmHg(1mmHg=0.133kPa)、(109.45±20.49)mmHg,均低于常规组(126.33±20.37)mmHg、(124.14±20.45)mmHg,P<0.05;颊针组术中丙泊酚用量、瑞芬太尼用量、术后30 min时的视觉模拟疼痛量表(VAS)评分、术后静脉自控镇痛泵(PCIA)按压次数分别为(30.23±5.16)mg、(1.22±0.34)mg、(2.75±0.22)分、(1.55±0.27)次,均低于常规组(33.29±5.41)mg、(1.85±0.36)mg、(3.28±0.46)分、(2.14±0.37)次,P<0.05;颊针组的去甲肾上腺素(NE)、皮质醇(Cor)、血管紧张素Ⅱ(AngⅡ)、催乳素(PRL)分别为(42.25±10.27)μg/L、(282.46±20.34)nmol/L、(27.55±5.15)ng/L、(13.23±3.16)μg/L,均低于常规组(47.23±10.35)μg/L、(294.25±20.41)nmol/L、(30.22±5.36)ng/L、(15.44±3.23)μg/L,P<0.05;颊针组的胃肠不良反应发生率4.00%(2/50)低于常规组22.00%(11/50),P<0.05。结论 颊针疗法辅助全身麻醉能稳定子宫全切术患者围术期血流动力学,对增强患者镇痛效果、减轻术后应激反应并降低胃肠不良反应发生风险均有积极意义。Objective To observe the application value of buccal acupuncture therapy in improving postoperative stress response and gastrointestinal reaction in patients with total hysterectomy.Methods This is a prospective study.100 patients undergoing total hysterectomy admitted to Kaifeng Obstetrics and Gynecology Hospital from January 2022 to February 2024 were selected as research objects by double-blind method.Random sequences were generated by computer randomization method and assigned and hidden,and the enrolled patients were classified into conventional group(50 cases)and buccal acupuncture group(50 cases),respectively.Conventional general anesthesia was given to the conventional group,and general anesthesia assisted by buccal acupuncture therapy was given to the buccal acupuncture group.Perioperative hemodynamics,perioperative pain,postoperative stress indexes and gastrointestinal adverse reactions were compared between the two groups.Results There was no significant difference in heart rate(HR)and mean arterial pressure(MAP)at 5 min(T1)after induction between the buccal acupuncture group and the conventional group under different anesthesia schemes(P>0.05).The HR of the buccal acupuncture group of T2(at intubation)and T3(at the end of operation)were(77.69±10.24)times/min and(75.33±10.21)times/min,respectively,lower than those of the conventional group([83.23±10.46]times/min and[80.44±10.27]times/min).MAP values of(110.25±20.43)mmHg(1 mmHg=0.133 kPa)and(109.45±20.49)mmHg were lower than those of the conventional group([126.33±20.37]mmHg,[124.14±20.45]mmHg),P<0.05;The amount of propofol,the amount of remifentanil,the visual analogue scale(VAS)at 30 min after operation,and the number of postoperative patient controlled intravenous analgesia(PCIA)compressions in the buccal acupuncture group were(30.23±5.16)mg,(1.22±0.34)mg,(2.75±0.22)scores and(1.55±0.27)times,respectively,lower than the conventional group([33.29±5.41]mg,[1.85±0.36]mg,[3.28±0.46]scores,[2.14±0.37]times),P<0.05;Norepinephrine(NE),cortis

关 键 词：子宫全切术 颊针疗法 血流动力学 术后应激 胃肠反应 

分 类 号：R614[医药卫生—麻醉学]