耳穴贴压对上肢闭合性骨折患者术后伤口疼痛的护理干预效果研究

Nursing intervention effect of auricular point sticking on pain of patients with closed fracture of upper limb after operation

目的：探讨耳穴贴压对减轻上肢闭合性骨折患者术后伤口疼痛的效果。方法：首先进行选穴：根据患者上肢骨折的手术部位和术后诊断选取耳穴并进行贴压。取肾、肾上腺、神门、皮质下为主穴,取肩、肘、腕穴为辅穴;尔后进行耳穴贴压：在患者术后返回病房0.5 h内,使用75%酒精棉球消毒耳郭待干,采用压痛法用探针以轻、慢而均匀的压力寻找压痛敏感点,确认贴压治疗的耳穴刺激点。用莱菔子耳穴贴在相应穴位上贴敷,并予适当按压,使耳郭有发热、胀痛感（即得气）。每个穴位以60~80次/min的频率进行按压,每次5 min左右,以患者感觉到酸、麻、胀为度,每3 h行1次,夜间入眠后则适当延长按压间隔时间,双耳交替。对照组患者实施常规心理护理干预。遵医嘱口服西乐葆镇痛。采用SPSS19.0软件进行统计学分析。结果：试验组患者术后4 h、8 h、12 h、24 h及48 h的疼痛程度较对照组减轻,使用西乐葆止痛的病例减少,差异有统计学意义（P〈0.05）。结论：上肢闭合性骨折术后的患者,采用耳穴贴压护理干预可有效地减轻术后疼痛,降低止痛药的使用。

Objective： To explore the effect of auricular point sticking on pai.n of patients with closed fracture of upper limb after operation. Methods： Firstly, the acupoint was selected： auricular point sticking was given based on the acupoint selection according to the surgical site and postoperative diagnosis of upper limb fracture. Acupoints in Kidney, adrenal gland, Shemnen, subcortical acupoint were selected as the main point and acupoints in shoulder, elbow and wrist were selected as minor points. Secondly, auricular point sticking was applied： 30 minutes after operation, auricular point sticking was given and corresponding massage was given. Each auricular point was massaged at the frequency of 60 - 80 times/min, which lasted 5 min, at the interval of 3 hours. The treatment during night was prolonged. The control group received routine psychological nursing intervention and Celebrex analgesia. SPSS19.0 software was used for statistical analysis. Results： The pain degree of the study group patients 4 h, 8 h, 12 h, 24 h and 48 h after operation was significantly relieved and the cases who needed Celebrex analgesia decreased, the difference was of statistical significance （P 〈 0.05）. Conclusion： Auricular point sticking could effectively relieve the pain of patients with closed fracture of upper limb after operation and decrease the usage of Celebrex analgesia.