耳穴埋豆预防乳腺包块切除术全麻诱导时舒芬太尼诱发呛咳反应的研究  

Study on the prevention of sufentanil-induced cough reflex during general anesthesia induction of breast mass resection by auricular point bean embedding

作　　者：罗锐 李瑶 吴永利 王薇薇[1] LUO Rui;LI Yao;WU Yongli;WANG Weiwei(Department of Anesthesiology,Sichuan Second Hospital of Traditional Chinese Medicine,Chengdu 610000,China;Department of Ultrasound,Jinjiang Daguan Hospital,Chengdu 610000,China)

机构地区：[1]四川省第二中医医院麻醉科,成都610000 [2]成都锦江大观医院超声科,成都610000

出　　处：《药物流行病学杂志》2025年第4期391-397,共7页Chinese Journal of Pharmacoepidemiology

基　　金：四川省中医药科学院中医研究所科研课题(2023610)。

摘　　要：目的探讨耳穴埋豆对乳腺包块切除术全麻诱导时舒芬太尼诱发呛咳反应的预防作用。方法回顾性收集2021年6月—2023年5月行择期乳腺包块切除术麻醉方式为全麻患者的临床资料。根据干预措施分为观察组(术前行耳穴埋豆疗法)和对照组(未行耳穴埋豆疗法)。采用倾向性评分匹配(PSM)法对2组患者的基本资料以1∶1比例进行匹配。利用重复测量方差分析对生命体征参数的时间、组间和交互效应进行检验;广义估计方程(GEE)分析术后不同时间点的疼痛视觉模拟量表(VAS)评分;Log-binomial回归模型分析不同干预措施对术后不良反应发生及其亚型的影响。结果PSM后,2组各纳入50例患者。2组患者收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))的时间、组间和交互效应均有统计学意义(P<0.05)。2组患者在进入手术室平躺后5 min(T0)、舒芬太尼注射即刻(T1)、注射后2 min(T2)、插管前1 min(T3)、插管后1 min(T4)时,组内SBP、DBP、MAP、HR、SpO_(2)差异均有统计学意义(P<0.05)。T2时,观察组SBP、DBP、MAP、HR均明显低于对照组,SpO_(2)明显高于对照组(P<0.05)。观察组的呛咳控制良好率、术后VAS评分和术后不良反应总发生率明显优于对照组(P<0.05)。GEE模型分析结果显示,观察组患者术后VAS评分改善情况优于对照组(P<0.05)。结论术前耳穴埋豆治疗对乳腺包块切除术患者全麻诱导时舒芬太尼诱发呛咳反应具有一定的预防作用。Objective To explore the preventive effect of auricular point bean embedding on sufentanil-induced cough reflex during induction of general anesthesia undergoing breast mass resection.Methods Clinical data of patients undergoing elective mammary mass resection with general anesthesia from June 2021 to May 2023 were retrospectively collected.The patients who received auricular point bean embedding therapy before surgery were included in the observation group,and patients who did not receive auricular point bean embedding therapy before surgery were included in the control group.The propensity score matching(PSM)method was used to perform 1∶1 matching based on basic data.The time effect,intergroup effect and interaction effect of vital signs parameters were analyzed by repeated measures analysis of variance.The GEE was used to analyze visual analogue scale(VAS)at different time points after operation.The Log-binomial regression model was used to analyze the incidence of postoperative adverse reactions and the association between subtypes.Results After PSM,50 patients were included in the observation and control groups.The time effect,intergroup effect and interaction effect of systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),heart rate(HR)and blood oxygen saturation(SpO_(2))in 2 groups were statistically significant(P<0.05).Within the same group,SBP,DBP,MAP,HR and SpO_(2) were statistically significant at immediately after intravenous sufentanil injection(T1),2 min after injection(T2),1 min before intubation(T3)and 1 min after intubation(T4)(P<0.05).At T2,SBP,DBP,MAP and HR in the observation group were significantly lower than those in the control group,and SpO_(2) was significantly higher than that in the control group(P<0.05).The cough control,VAS score and total incidence of postoperative adverse reactions in the observation group were significantly better than those in the control group(P<0.05).The result of GEE model analysis showed that the improvement of postoperative

关 键 词：耳穴埋豆 舒芬太尼 乳腺包块切除术 呛咳反应 预防 广义估计方程 

分 类 号：R245.91[医药卫生—针灸推拿学]