穴位按压与氟马西尼协同在妇科腹腔镜全麻术后患者催醒中的效果观察

Effect of acupoint pressing combined with flumazenil on resuscitation of patients with general anesthesia for gynaecological laparoscopy

目的探讨穴位按压与氟马西尼协同对妇科腹腔镜全麻术后患者催醒的效果及护理对策。方法选择行妇科腹腔镜择期手术患者90例,采用随机数字表法随机将患者分为F组(氟马西尼组)、XF组(穴位按压与氟马西尼协同组)、C组(空白组)3组,每组各30例。观察术毕时(T1)、达到清醒标准时(T2)、拔除气管导管后15min(T3)的平均动脉压(MAP)、心率(HR)、呼气末二氧化碳分压(PETCO2)、血氧饱和度(SPO2)、改良的警觉-镇静(OAA/S)评分、脑电双频谱指数(bispectralindex,BIS)值;同时记录达到清醒评定标准的时间。结果 MAP,HR在T3时点XF组较其他组高(均P<0.05),C组HR最低;PETCO2、SPO2在相应时间点各组间比较(均P>0.05);BIS在T2时点,C组低于其他组(均P<0.05),在T3时点,各组组间比较(均P<0.05),其中XF组最高。改良的OAA/S评级在T3时点,XF组与其他组比较(均P<0.05)。复苏时间比较,XF组快于其他组(均P<0.05),C组最慢。结论穴位按压与氟马西尼协同用于妇科腹腔镜全麻术后复苏可取得良好效果,提高了麻醉复苏的质量,保证了临床医疗安全。

Objective To explore the effect of acupoint pressing combined with flumazenil on resuscitation of patients with general anesthesia for gynaecological laparoscopy. Methods 90 patients undergoing selective gynaecological laparoscopy were equally divided into group F, group XF and blank control group （group C）. MAP, HR, PETCO2, SPO2, Improved OAA/S, BIS of all patients were observed at the end of operation （T~）, at the time for conscious standard （T2）, and 15 rains after withdrawal of tracheal catheter（T3）. Results MAP was increased significantly in group XF than in group F and control group at T3 （P 〈 0.05）. HR in group XF was higher than that in the other groups （P 〈 0.05） and that in group C was lowest （P 〈 0.05） at T3. PETCO2 and SPO2 had no significant differences between three groups （P 〉 0.05）. BIS was decreased significantly in group C than that in the other groups at T2 （P 〈 0.05）, and BIS showed significant difference between three groups at T3 （P 〈 0.05 ）. Improved OAA/S in group XF was more stable than those in group F and group C at T3（P 〈 0.05 ）, but showed no differences between the three groups at other time points （P 〉 0.05）. The time for resuscitation in group XF was shorter than those in the other two groups and the time in the control group was the longest （P 〈 0.05）. Conclusions Acupoint pressing combined with flumazenil is effective in the resuscitation of patients undergoing general anesthesia for gynaecological laparoscopy. It helps for the clinical safety.