腕踝针在全髋关节置换术围手术期镇痛效果的临床观察

Evaluation of Analgesia Effect of Wrist-Ankle Acupuncture on Perioperative Period of Total Hip Arthroplasty

目的:观察腕踝针在全髋关节置换术围手术期镇痛的疗效。方法:将68例接受单侧全髋关节置换术(THA)的患者随机分为治疗组35例、对照组33例。两组患者术前均进行疼痛知识宣教,术后均使用自控镇痛泵(patient controlled analgesia,PCA)镇痛48 h。治疗组在上述治疗的基础上从术前3 d开始给予腕踝针针刺疗法。采用VAS疼痛评分评估两组患者术后疼痛程度,Harris评分评估患者髋关节功能,记录不同时间PCA用量及使用PCA期间不良反应发生情况。结果:(1)术后3、4、5 d时治疗组VAS评分均低于对照组(P<0.05)。(2)术后两组患者各时间段镇痛药物用量比较,差异均有统计学意义(P<0.05)。(3)术后2周时治疗组Harris评分高于对照组(P<0.05)。(4)术后48 h治疗组发生恶心呕吐的例数低于对照组(P<0.05),出现尿潴留、眩晕嗜睡、呼吸抑制的例数比较,差异均无统计学意义(P>0.05)。结论:在THA围手术期应用腕踝针,术后镇痛效果及近期髋关节功能恢复较好,可减少术后镇痛药物用量及恶心呕吐发生率。

Objective： To observe the clinical analgesia effect of Wrist-Ankle acupuncture on perioperative period of total hip arthroplasty. Methods： The 68 patients treated with unilateral THA, were randomly divided into treatment group （35 cases） and control group （33 cases）. All patients were given pain knowledge education before the operation and received patient controlled analgesia pump （PCA） for 48 hours after surgery. Moreover, the patients in treatment group were given Wrist-Ankle acupuncture therapy 3 days before operation. VAS score was used to evaluate the degree of pain; Harris score was used to evaluate the function of hip joint. The dosage of liquids and adverse reaction of PCA pump in different time were recorded.Results： The treatment group showed lower VAS scores than the control group, 3, 4, 5 day after the operation. The analgesic dosage of the treatment group was less than that of the control group at each time period after operation. The treatment group showed higher Harris hip scores than control group, 2 weeks after the operation. During the using of PCA, treatment group showed less cases of nausea and vomiting than control group （P〈0.05）. There was no sta- tistical difference on Urinary retention, dizziness and sleepiness and respiratory depression between the two groups （P〉0.05）. Conclusion： Wrist-Ankle acupuncture on perioperative period of total hip arthroplasty can reduce the dosage of analgesic drugs and incidence of nausea and vomiting. The effect of postoperative analgesia and the recovery of hip function in the near future were better.