针刺联合托烷司琼治疗剖宫产术中卡前列素氨丁三醇诱发恶心呕吐的效果

Efficacy of acupuncture combined with tropisetron in treating nausea and vomiting induced by carboprost tromethamine in cesarean section

目的 评价针刺联合托烷司琼治疗剖宫产术中卡前列素氨丁三醇诱发恶心呕吐的效果.方法 择期腰麻下剖宫产术中应用卡前列素氨丁三醇后发生恶心呕吐的患者66例,年龄22～40岁,采用信封法将患者随机分为3组（n=22）：针刺组（A组）静脉注射生理盐水2 ml,针刺人中、内关及合谷,留针10 min;托烷司琼组（T组）静脉注射托烷司琼10 mg,针仅接触人中、内关及合谷皮肤表面;针刺＋托烷司琼组（AT组）静脉注射托烷司琼10 mg,针刺人中、内关及合谷,留针10 min.分别于麻醉前（T0）、发生恶心或呕吐时（T1）、针刺或给药后1 min（T2）、3 min（T3）、5 min（T4）及15 min （T5）时行恶心呕吐评分.记录患者对治疗效果的满意度评分.结果 与A组比较,AT组T4时恶心呕吐评分降低,患者满意度评分升高（P〈0.05）;与T组比较,AT组T2-T4时恶心呕吐评分降低,患者满意度评分升高（P〈0.05）.结论 针刺联合托烷司琼可快速有效缓解剖宫产术中卡前列素氨丁三醇诱发的恶心呕吐.

 Objective To evaluate the efficacy of acupuncture combined with tropisetron in treating nausea and vomiting induced by carboprost tromethamine in cesarean section. Methods Sixty-six patients aged 22-40 yr who received carboprost tromethamine and developed nausea and vomiting during cesarean section under lumbar anesthesia, were randomly divided into 3 groups（n=22 each）： acupuncture group （group A）, tropisetron group（group T）and acupuncture＋ tropisetron group（group AT）. In group A, 09% normal saline 2 ml was intravenously injected immediately, acupuncture was given at Renzhong, Neiguan and Hegu acupoints with lifting thrusting twirling the acupuncture needle for 10 min. In group T, tropisetron 10 mg was intravenously injected immediately, the needle was placed on Renzhong, Neiguan and Hegu skin surface. In group AT, tropisetron 10 mg was intravenously injected immediately, acupunc-ture was given at Renzhong, Neiguan and Hegu acupoints with lifting thrusting twirling the acupuncture nee-dle for 10 min. The nausea and vomiting score was assessed before anesthesia induction（T0）, when nause-a or vomiting occurred（T1）and at 1, 3, 5 and 15 min after acupuncture or administration（T1-5）. The degree of patient′s satisfaction with therapeutic effect was recorded. Results Compared with group A, the nausea and vomiting scores were significantly decreased at T4, and the patient＇s satisfaction score was in-creased in group AT（P〈0.05）. Compared with group T, the nausea and vomiting scores were significantly decreased at T2-4and the patient＇s satisfaction score was increased in group AT（P 〈0.05）. Conclusion Acupuncture combined with ondansetron can quickly and effectively relieve the nausea and vomiting induced by carboprost tromethamine during cesarean section.