针药结合麻醉下手术治疗混合痔40例临床观察

Clinical Observation on the Effect of Acupuncture-assisted Anesthesia for 40 Cases of Mixed Hemorrhoids Surgery

目的:评价针药结合麻醉在手术治疗混合痔中的效果。方法:40例混合痔患者随机分为针药结合麻醉组20例和药物麻醉组20例。针药结合麻醉组以1%利多卡因5mL注入长强穴,同时电针针刺腰俞穴、长强穴20min。药物麻醉组以1%利多卡因20mL注入腰俞穴,10mL注入长强穴。比较两组麻醉有效率及术后发生尿潴留、疼痛,术中发生毒性反应的情况。结果:两组麻醉有效率无明显差异,均为100%(P>0.05),但术后不良反应的发生率针药结合麻醉组与药物麻醉组相比差异均有统计学意义(P<0.05),针药结合麻醉组明显少于药物麻醉组。结论:针药结合麻醉在肛肠科手术中麻醉作用肯定,术后并发症发生少,适合临床进一步应用和研究。

Objective To observe the efficacy of comined administration of acupuncture and anesthetics for mixed hemorrhoids surgery and its postoperative complications. Methods A total of 40 cases of mixed hemorrhoid patients were randomized into acupuncture-assisted anesthesia （AAA） group and narcotic drug group （control）, with 20 cases in each. For patients of AAA group, electroacupuncture （EA, 2 Hz/100 Hz, 9 mA） was applied to Ohangqiang （GV 1） and Yaoshu （GV 2） for 20 min, and 1% lidocaine （5 mL） was injected into GV 1. For patients of control group, 20 mL and 10 mL of 1% lidocaine were injected into GV 2 and GV 1, separately. The patients＇ pain response, anus muscular relaxion state, and postoperative complications were observed to evaluate their clinical efficacy. Results Of the 20 cases in AAA and control groups, 16 and 18 cases had a striking analgesic effect, 4 and 2 were effective, respectively. No significant difference was found between two groups in the analgesic efficacy for surgery（P〉0.05）. Postoperative urinary retention, pain severity Ⅰ and Ⅱ and the cases with intoxic response in AAA and control groups were 1 and 8, 16 and 6, 4 and 14, and 1 and 9, separately. The effects of AAA group were significantly superior to those of control group in lessening urinary retention and toxication, and in inducing analgesia （P〈0.05）. Conclusion Acupuncture combined with narcotic drugs is superior to simple anesthetics for mixed hemorrhoids surgery in reducing postoperative complications.