耳穴贴压干预胫腓骨骨折术后疼痛的临床观察

Clinical observation of intervention of auricular application on postoperative pain of tibia and fibula fracture

目的观察耳穴贴压疗法干预胫腓骨骨折术后疼痛的临床疗效。方法将66例胫腓骨骨折患者随机分为治疗组与对照组,每组33例。两组均在连续硬膜外麻醉下行胫骨骨折髓内钉内固定联合腓骨骨折切开复位内固定术,术后予电控式止痛注液泵注射预混镇痛液。对照组术后采用基础护理干预,治疗组在基础护理的基础上加用耳穴贴压治疗。两组疗程均为术后72 h,观察评价术后护理满意度,比较疼痛数字评分(NRS)、镇痛泵残液量及镇痛液追加次数。结果 (1)术后各时点与术前组内比较,两组NRS评分均明显降低(P<0.05),且呈随时间增加而降低程度更加明显的趋势(P<0.05)。组间术后各时点比较,NRS评分差异均有统计学意义,治疗组均明显低于对照组(P<0.05)。(2)术后72 h回收时发现,治疗组镇痛泵残液量明显多于对照组(P<0.05);治疗组镇痛泵追加次数明显少于对照组(P<0.05)。(3)术后3 d评价,治疗组、对照组护理总体满意度分别为90.0%、69.7%;组间护理满意度比较,差异均有统计学意义(P<0.05)。结论耳穴贴压可明显缓解胫腓骨骨折术后患者的疼痛不适,提高其护理满意度。

Objective To observe the clinical efficacy of auricular application therapy on the postoperative pain of tibia and fibula fracture. Methods 66 patients with tibia and fibula fracture were randomly divided into the treatment group and control group,33 cases in each group. Under the continuous epidural anesthesia,the patients in both groups were performed the internal fixation of intramedullary nailing for tibia fracture combined with open reduction and internal fixation for fibula fracture. After surgery,the premixed analgesic solution was injected by electric controlled analgesic injection pump. After operation,the control group was treated with basic nursing and the treatment group was treated with auricular application based on the basic nursing,with a course of 72 hours. The satisfaction of postoperative nursing was observed. The numerical rating scale（ NRS） score,residual solution amount in analgesic pump and supplementary times of analgesic solution were compared. Results（1）Compared with operation before,the NRS scores in both groups were obviously decreased at each timepoint after operation（ P〈0.05）,which showed a tendency of gradually obvious reduction over time（ P〈0.05）. There were statistically significant differences on NRS scores between the two groups at each timepoint after operation,and the scores in the treatment group were obviously lower than those in the control group（ P〈0.05）.（2）72 hours after operation,the residual solution amount in analgesic pump in the treatment group was obviously more than that in the control group（ P〈0.05）,and the supplementary times of analgesic solution in the treatment group was obviously less than that in the control group（ P〈0.05）.（3）3 days after operation,the overall satisfactions of nursing were 90.0% in the treatment group and 69.7% in the control group,there was statistically significant difference on the satisfaction of nursing between the two groups（ P〈0.05）. Conclusion The auricular application therapy can obviously relieve the pain and discomfort in postoperative patients following tibia and fibula fracture,and improve the satisfaction of nursing.