电针复合耳穴埋籽对妇科开腹手术患者术后恶心呕吐的影响

杨光; 李莎; 郑曼

doi:10.16766/j.cnki.issn.1674-4152.002203

电针复合耳穴埋籽对妇科开腹手术患者术后恶心呕吐的影响

doi: 10.16766/j.cnki.issn.1674-4152.002203

南京中医药大学附属医院麻醉科，江苏南京 210029

基金项目:

江苏省卫生计生委2018年度医学科研课题 H2018107

详细信息

通讯作者:
李莎，E-mail: 262491796@qq.com

中图分类号: R713 R245.97
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出版历程
- 收稿日期: 2020-11-19
- 网络出版日期: 2022-02-15

Effect of electroacupuncture combined with ear point seed embedding on postoperative nausea and vomiting in patients undergoing gynaecological laparotomy

Department of Anesthesiology, Affiliated Hospital of Nanjing University of TCM, Nanjing, Jiangsu 210029, China

摘要

摘要: 目的观察术前1 d电针复合术后耳穴埋籽对妇科开腹手术患者术后恶心呕吐(postoperative nausea and vomiting，PONV)的影响。方法选择2016年12月—2018年12月在南京中医药大学附属医院行妇科开腹手术的患者90例，采用随机数字表法分为术前电针组(A组)、术后耳穴埋籽组(B组)和术前电针复合术后耳穴埋籽组(C组)。A组术前1 d进行电针治疗，B组术后耳穴埋籽治疗，C组术前1 d电针复合术后耳穴埋籽治疗。记录患者术后6、24、48 h恶心、呕吐发生率，术后使用止吐药情况，术后首次通气时间，VAS评分。结果 3组患者中，C组患者术后6、24 h的术后恶心(PON)和术后呕吐(POV)的发生率最低, 术后6 h PON的发生率为30.00%, POV的发生率为26.67%，术后24 h PON的发生率为33.33%，POV的发生率为.30.00%，差异有统计学意义(均P < 0.05)。C组患者术后首次通气时间[(19.44±3.36)h]明显缩短，且术后止吐药的使用率最低(30.00%)，差异有统计学意义(均P < 0.05)。3组患者术后48 h的PON和POV的发生率比较，差异无统计学意义(均P>0.05)。3组患者，术后6 h、24 h和48 h的疼痛评分比较差异无统计学意义(均P>0.05)。结论妇科开腹手术术前给予电针复合术后耳穴埋籽，可有效降低患者PONV的发生率，缩短术后首次通气时间，同时可以减少术后止吐药使用。
- 电针 /
- 耳穴埋籽 /
- 妇科开腹手术 /
- 术后恶心呕吐
Abstract: Objective To investigate the effectiveness of combined preoperative electroacupuncture (EA) and postoperative ear point seed embedding for postoperative nausea and vomiting (PONV) after gynaecological laparotomy. Methods Total 90 patients undergoing gynaecological laparotomy in Jiangsu Provincial Hospital of Traditional Chinese Medicine from December 2016 to December 2018 were randomly divided into the preoperative EA group (group A), postoperative ear point seed embedding group (group B) and preoperative EA combined with postoperative ear point seed embedding group (Group C). Group A was given EA one day before the operation, group B was given ear point seed embedding treatment after the operation, and group C was given EA combined with ear point seed embedding treatment one day before the operation. The incidence of nausea and vomiting at 6, 24 and 48 h after operation, the use of antiemetic drugs, the time of first ventilation after operation and VAS score were recorded. Results Compared with the other two groups, the incidence of postoperative nausea (PON) and postoperative vomiting (POV) in group C at 6 and 24 h after surgery were significantly lower (all P < 0.05). The incidence of PON and POV was 30.00% and 26.67% at 6 h and 33.33% and 30.00% at 24 h, respectively. Amongst the three groups, group C had the shortest time to passage of first flatus (19.44±3.36) h (P < 0.05) and the least consumption of antiemetics after surgery (30.00%, all P < 0.05). No significant differences were observed regarding the incidence of PON and POV at 48 h after surgery and VAS score at 6, 24 and 48 h after surgery in all groups (all P>0.05). Conclusion Combined EA and postoperative ear point seed embedding after gynaecological laparotomy could decrease the incidence of PONV, shorten the time to passage of first flatus and reduce the consumption of antiemetics.
- Electroacupuncture /
- Ear point seed embedding /
- Gynaecological laparotomy /
- Postoperative nausea and vomiting

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表 1 3组妇科开腹手术患者一般资料及围术期资料比较

组别	例数	年龄(x ±s，岁)	BMI(x ±s)	ASAⅠ/Ⅱ(例)	Apfel评分(x ±s，分)	手术时间(x ±s，min)	麻醉时间(x ±s，min)	术中输液量(x ±s，mL)	舒芬太尼使用量[x ±s，μg/(kg·h)]	瑞芬太尼使用量[x ±s，μg/(kg·h)]
A组	29	36.71±9.10	24.78±2.65	13/16	2.23±0.50	78.33±15.72	82.93±18.80	1 423.33±207.92	9.20±2.31	0.31±0.12
B组	29	37.20±8.81	24.71±2.98	15/14	2.17±0.42	79.50±15.88	86.53±16.13	1 423.33±204.57	9.00±1.61	0.29±0.08
C组	30	36.90±9.01	24.80±2.60	16/14	2.17±0.47	77.83±15.46	83.07±15.58	1 416.67±205.25	8.91±1.80	0.33±0.12
统计量		8.381^a	4.472^a	4.026^b	32.402^a	3.483^a	5.127^a	20.836^a	25.414^a	13.823^a
P值		0.613	0.578	0.861	0.587	0.902	0.976	0.908	0.267	0.861
注：^a为F值，^b为χ²值。

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表 2 3组妇科开腹手术患者术后恶心呕吐情况及术后首次通气时间比较

组别	例数	术后6 h[例(%)]		术后24 h[例(%)]		术后48 h[例(%)]		术后首次通气时间(x ±s，h)	术后使用止吐药[例(%)]
组别	例数	PON	POV	PON	POV	PON	POV	术后首次通气时间(x ±s，h)	术后使用止吐药[例(%)]
A组	29	16(55.17)	14(48.28)	18(62.07)	18(62.07)	10(34.48)	9(31.03)	31.17±3.25	21(72.41)
B组	29	19(65.52)	18(62.07)	23(79.31)	21(72.41)	12(41.38)	10(34.48)	30.14±4.29	18(62.07)
C组	30	9(30.00)^ab	8(26.67)^ab	10(33.33)^ab	9(30.00)^ab	6(20.00)	6(20.00)	19.44±3.36^ab	9(30.00)^ab
统计量		7.903^c	7.593^c	13.093^c	11.687^c	3.248^c	1.667^c	93.550^d	11.687^c
P值		0.019	0.022	0.001	0.003	0.197	0.434	< 0.001	0.003
注：与A组比较，^aP < 0.05；与B组比较，^bP < 0.05。^c为χ²值，^d为F值。

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表 3 3组妇科开腹手术患者术后VAS评分比较(x ±s，分)

组别	例数	术后6 h	术后24 h	术后48 h	F值	P值
A组	29	2.52±0.57	1.97±0.63^a	1.66±0.55^ab	15.789	< 0.001
B组	29	2.38±0.49	1.83±0.38^a	1.45±0.51^ab	25.509	< 0.001
C组	30	2.20±0.41	1.87±0.43^a	1.47±0.51^ab	19.694	< 0.001
F值		3.044	0.606	1.400
P值		0.053	0.548	0.252
注：与术后6 h比较，^aP < 0.05；与术后24 h比较，^bP < 0.05。

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