耳穴埋豆联合中药穴位贴敷预防妇科术后恶心呕吐的效果观察

Effect of burying beans at ear acupoints combining sticking Chinese medicine at acupoints to prevent nausea and vomiting after gynecological surgery

目的：观察耳穴埋豆联合中药穴位贴敷预防妇科术后恶心呕吐（ PONV）的效果。方法选择2011年12月至2012年11月开腹行妇科三类手术的患者作为观察组，2010年12月至2011年11月行同类手术的患者作为对照组。观察组患者给予双侧耳穴（胃、脾、交感）埋豆按压联合吴茱萸调生姜汁双侧内关穴贴敷，对照组术前未给予特殊的预防恶心呕吐的措施，术后如出现呕吐，则给予药物注射对症处理。观察两组患者术后24 h PONV发生率及严重程度。结果观察组44例中发生PONVⅠ级30例（68．18％），Ⅱ级4例（9．09％），Ⅲ级10例（22．73％）；对照组52例患者中，发生 PONVⅠ级23例（44．23％），Ⅱ级7例（13．46％），Ⅲ级22例（42．31％），两组患者PONV发生率比较，差异有统计学意义（Uc ＝2．3322，P＜0．05）。观察组恶心呕吐程度轻，PONV Ⅲ级时经单一用药均能缓解。结论耳穴埋豆联合中药穴位贴敷能降低妇科PONV的发生率，护士易于操作，可在临床推广应用。

Objective To observe the effect of burying beans at ear acupoints combining sticking Chinese medicine at acupoints to prevent nausea and vomiting after gynecological surgery .Methods Patients who undergone three kinds of abdominal gynecological operations from December 2011 to November 2012 were chosen as the observation group , and those from December 2010 to November 2011 were chosen as the control group.The observation group applied burying beans at ear acupoints combining sticking Chinese medicine at acupoints to prevent nausea and vomiting while the control group had no special preoperative preventive measures but give medicine after the surgery to deal with symptoms .The incidence rate of PONV and its severity in 24 hours after surgery was observed and compared between two groups .Results There were 44 cases （68.18%） of GradeⅠPONV, 4 cases （9.09%） of GradeⅡ PONV, 10 cases （22.73%） of Grade Ⅲ PONV in the observation group, and 23 cases （44.23%） of GradeⅠPONV, 7 cases （13.46%） of GradeⅡ PONV, 22 cases （42.31%） of Grade Ⅲ PONV in the control group.And the difference of incidence of PONV was statistically significant between two groups （Uc=2.3322, P〈0.05）.The severity of nausea and vomiting was better in the observation group and single medication can relieve symptoms during Grade Ⅲ PONV. Conclusions Burying beans at ear acupoints combining sticking Chinese medicine at acupoints can prevent incidence of PONV after gynecological surgery , which is easy for nurses to implement and worthy clinical promotion.