姜醋泥穴位贴敷对全麻下髋膝关节置换术后恶心呕吐的临床研究

Clinical study on acupoint application of Ginger Vinegar Mud on nausea and vomiting after total hip and knee joint replacement

目的 观察姜醋泥贴敷神阙穴,对全身麻醉下髋、膝关节置换（THA/TKA）术后恶心呕吐（PONV）的临床疗效,为应用姜醋泥治疗PONV提供依据.方法 选择全身麻醉下行THA/TKA患者80例,按随机数字表法分为试验组和对照组各40例.2组THA/TKA患者手术结束回病房后,按照THA/TKA临床路径进行常规药物治疗及护理,试验组在此基础上,应用姜醋泥贴敷神阙穴,对照组给予外观相同的敷料贴敷.分别记录并比较2组术后0-8 h、9-12 h、13-24 h PONV发生率.结果 试验组0-8 h恶心、呕吐的发生率为25%（10/40）,15%（6/40）,9-12 h为20%（8/40）,10%（4/40）,13-24 h为10%（4/40）,0;对照组则分别为55%（22/40）,30%（12/40）;40%（16/40）,25%（10/40）;30%（12/40）,15%（6/40）,2组比较差异有统计学意义（χ^2=58.23~80.23,均P〈0.01）.结论 用姜醋泥穴位贴敷能减少全身麻醉下THA/TKA患者PONV的发生率,疗效显著,值得临床推广.

Objective To observe the clinical curative effect of Ginger Vinegar Mud sticking on Shenque acupoint on postoperative nausea and vomiting （PONV） aftertotal hip/knee arthroplasty （THA/TKA）, which can provide the basis for application of Ginger Vinegar Mud treatment. Methods A total of 80 patients who used the general anesthesia, were chosen according to the stochastic indicator method. They were divided into the experimental group and the control group with 40 cases in each group.The patients in both groups were given routine drug treatment and nursing according to the THA/TKA clinical pathway, based on this, the experimental group used Ginger Vinegar Mud to stick Shenque acupoint, while the control group was given dressings of the same appearance. The incidence of PONV was recorded 0-8 h, 9-12 h,13-24 h after surgery respectively. Results The incidence of nausea and vomiting in the experimental group 0-8 h was 25%（10/40）, 15%（6/40）,9-12 h was 20%（8/40）, 10%（4/40）,13-24 h was 10%（4/40）, 0. While in the control group, they were 55%（22/40）, 30%（12/40）;40%（16/40）, 25%（10/40）; 30% （12/40） and 15%（6/40） respectively. The difference between the two groups was statistically significant （χ^2 =58.23-80.23, P〈0.05）. Conclusions Using Ginger Vinegar Mud to stick Shenque acupoint can reduce the incidence rate of PONV under general anesthesia, the effect is distinct and this method is worthy of clinical promotion.