耳穴贴压超前镇痛在肛瘘术后镇痛中的疗效观察

Preemptive Analgesia by Ear-Acupoint-Compression for Postoperative Pain of Anal Fistula： Efficacy Observation

为了观察应用王不留行籽耳穴贴压超前镇痛在肛瘘切除术后疼痛中的疗效，将2014年8月至2015年12月行肛瘘切除术的64例患者随机分为观察组和对照组，每组各32例。对照组采用常规镇痛治疗，即术后予消炎痛栓塞肛，镇痛效果不佳时可予双氯芬酸钠缓释胶囊口服。观察组在术前30min加用王不留行籽耳穴贴压超前镇痛治疗，术后予消炎痛栓塞肛，镇痛效果不佳时亦予双氯芬酸钠缓释胶囊口服。术后30min、术后1d、术后3d对患者进行疼痛评分，同时记录2组患者双氯芬酸钠缓释胶囊使用量及不良反应情况。结果显示，观察组术后30min、1d、3d的疼痛评分分别为（2．9±1．2）、（2．6±0．8）、（1．9±1．5），对照组同期的疼痛评分分别为（4．5±1．6）、（4．0±1．4）、（3．3±1．1），观察组显著低于对照组（P〈0．01）。观察组双氯芬酸钠缓释胶囊使用率亦低于对照组，且不良反应少。观察组不良反应总发生率15．6％（5／32），对照组不良反应总发生率46．9％（15／32），对照组不良反应发生率明显高于观察组（P=0．00）。结果表明，耳穴贴压超前镇痛可明显缓解肛瘘切除术后疼痛，且不良反应少。

This study was to observe the effect of preemptive analgesia by vaccariae seed performing earacupoint compression for postoperative pain of anal fistula;divided 64 cases received anal fistulectomy from August 2014 to December 2015 into observation group and control one randomly,32 cases for each. The control group received routine analgesia treatment,namely,putting indomethacin suppository into anus after the surgery,if not getting effective analgesia, taking diclofenac sodium sustained release capsules. The observation group was added vaccariae seed performing ear-acupoint compression at the 30 min before surgery based on the control group. At the 30 min,1 d,3 d after the surgery,patients＇ pain was scored,and the using volume ＆ adverse reaction of the diclofenac sodium sustained release capsules were recorded. As results,the pain scores on the observation group at postoperative 30 min,1 d,3 d were （2.9±1.2）, （2.6±0. 8）,（1.9±1.5）,respectively while the pain scores on the control group at the same time （4.5±1.6）,（4.0±1.4）, （3.3±1.1）,respectively. The former was obviously lower than the latter （ P 〈0.01）. And in the usage rate and adverse reaction of the diclofenac sodium sustained release capsules,the former was lower and less than the latter.In the total occurrence rate of adverse reaction the former was 15.6% （5/32） and the latter was 46.9% （15/32）;the latter was obviously higher than the former （ P =0.00）. In conclusion,preemptive analgesia by ear-acupoint compression can significantly ease the postoperative pain of anal fistula surgery and have less adverse reaction.