腕踝针用于腹腔镜胃肠手术患者术后镇痛的研究

The Study of Wrist Ankle Acupuncture for Postoperative Analgesia in Patients Undergoing Laparoscopic Gastrointestinal Surgery

目的探讨腕踝针对腹腔镜胃肠道手术患者术后镇痛作用并评价其疗效。方法选择ASAⅠ-Ⅱ级择期行快速康复外科（fast-track surgery,FTS）腹腔镜胃肠手术的患者40例,随机分为腕踝针（wrist-ankle acupuncture,WAA）＋患者静脉自控镇痛（patient-controlled intravenous analgesia,PCIA）组,WAA组和PCIA组（对照组）各20例,在麻醉结束后于麻醉后恢复室（post-anesthesia care unit,PACU）中开始使用PCIA镇痛。WAA组同时行腕踝针治疗并留针12h,分别在术后各时段评估患者基本生命体征（血压、呼吸、心率和脉搏氧饱和度）、疼痛VAS评分、PCIA用量、实际按压次数、睡眠满意度、肛门排气时间及恶心呕吐等不良反应发生率。结果 WAA组术后2、6、12、24h疼痛VAS评分,PCIA用量,实际按压次数均明显低于对照组,差异有统计学意义（P〈0.05）,睡眠满意度高于对照组,差异有统计学意义（P〈0.05）。相比对照组,WAA组患者排气时间缩短,恶心呕吐等不良反应发生率较低,差异有统计学意义（P〈0.05）。两组患者术后基本生命体征差异无统计学意义（P〉0.05）。结论腕踝针联合PCIA用于腹腔镜胃肠道手术是一种较佳的多模式镇痛方案。

Objective To investigate the effect of wrist ankle acupuncture on postoperative analgesia in patients with laparoscopic gastrointestinal surgery. Methods ASA I-II,undergoing rapid rehabilitation surgery（ fast-track surgery,FTS） laparoscopic gastrointestinal surgery in 40 patients,were randomly divided into wrist ankle acupuncture（ Wrist-Ankle and,WAA） ＋ patient controlled intravenous analgesia（ patient-controlled intravenous analgesia,patient controlled intravenous analgesia（ PCIA） group（ WAA） group and PCIA group（ control group）,each group of 20 cases. At the end of anesthesia in the post-anesthesia care unit（ post-anesthesia care unit,PACU） began using PCIA analgesia. WAA group at the same time,took wrist ankle acupuncture and needle for 12 h,respectively,in postoperative each time assessment of patients with basic vital signs（ blood pressure,respiration,heart rate and pulse oxygen saturation）,VAS pain score,dosage in the PCIA,actual pressing times,satisfaction with sleep,anal exhaust time and nausea and vomiting vomiting adverse reaction incidence. Results VAS pain score,dosage in the PCIA,actual pressing times of the WAA group was less than the control group 2、6、12、24h after surgery,significantly（ P〈0. 05）. The satisfaction with sleep was significantly higher than control group（ P〈0. 05）. Compared with the control group,the WAA group patients with lower exhaust time,nausea and vomiting and other adverse reaction rates were lower,the difference was statistically significant（ P〈0. 05）. There was no significant difference in basic vital signs between the two groups（ P〈0. 05）. Conclusion Wrist ankle acupuncture combined with PCIA for laparoscopic gastrointestinal surgery is a better mode of multimodal analgesia.