针刺配合指压法对妇科腹腔镜手术后恶心呕吐症的干预研究

Study on Intervention of Acupuncture Combined with Acupressure on the Nausea and Vomiting Syndromes in Gynecological Laparoscopic Surgery

目的:观察比较针刺内关配合腧穴、指揉按压法在妇科腹腔镜手术后恶心呕吐症中的干预研究。方法:选择ASAⅠ-Ⅱ116例妇科腹腔镜手术患者,随机分为五组:针刺指揉组(AF,n=23)、恩丹西酮组(OH,n=23)、甲氧氯普胺组(MP,n=23)、氟哌利多组(DR,n=23)和生理盐水组(NS,n=24)。实施全凭静脉麻醉及术后镇痛(patient controlled intravenous analgesia,PCIA)。常规连续监测收缩压(SBP)、舒张压(DBP)、心率(HR)、血氧饱和度(SpO2)外,采用A-Line麻醉-镇静深度监测仪监测听觉诱发电位指数(AAI)值,指导麻醉药物的使用。结果:针刺指揉组、恩丹西酮组、甲氧氯普胺组与氟哌利多组VAS评分相当,与生理盐水组比较P<0.01,各试验组之间比较P>0.05,表明针刺指揉组、恩丹西酮组、甲氧氯普胺组和氟哌利多组疗效相同。结论:针刺配合指揉按压法在防治妇科腹腔镜恶心呕吐中适用于轻、中度恶心呕吐。

Objective：To perform the intervention study of acupuncturing point P6 combined with point acupressure on the nausea and vomiting syndromes in the gynecological laparoscopic surgery.Methods：Choose 116 patients treated with gynecological laparoscopic surgery in ASA grade I-II,who were randomly divided into five groups：Acupuncturing and acupressure group（AF,n=23）,Ondansetron Hydrochloride group（OH,n=23）,Metoclopramide group（MP,n=23）,Droperidol group（DR,n=23） and Sodium choloride injection group（NS,n=24）.In addition to routine continuous monitor of SBP,DBP,HR,SpO2,the A-Line anesthesia or sedation deep monitoring was adopted to monitor AAI values and guide the use of narcotic drugs.Results：The visual analogue scale（VAS） scores of group AF,group OH,group MP and group DR were basically equal,compared with group NS（P0.01）.Comparison between each group showed P0.05,which meant that group AF,group OH,group MP and group DR achieved the same effects.Conclusion：Acupuncture combined with acupressure is applicable for the mild and moderate nausea and vomiting in the prevention and treatment of nausea and vomiting syndromes in the gynecological laparoscopic surgery.