耳穴埋豆、穴位贴敷及镇痛泵在二胎产妇产后子宫收缩痛中的应用

Application of ear-point bean-embedding,acupoint sticking and analgesia pump in postpartum uterine contraction pain of second pregnancy

目的探讨耳穴埋豆、穴位贴敷及镇痛泵在二胎产妇产后子宫收缩痛中的应用效果。方法随机将150例行剖宫产术的二胎产妇等分为对照组和观察组,对照组术毕给予静脉自控镇痛泵(PCIA)的镇痛护理,观察组给予耳穴埋豆联合穴位贴敷的镇痛措施,对比两组患者术后疼痛、镇痛效果、舒适度、胃肠道恢复情况、泌乳及哺乳情况、不良反应发生情况。结果术后2 h(T1)、6 h(T2)、24 h(T3)两组患者切口疼痛、宫缩疼痛的视觉模拟评分法(VAS)评分呈显著升高趋势(P <0. 05),组内不同时间点对比差异有统计学意义(P <0. 05),组间对比差异无统计学意义(P> 0. 05);两组患者术后24 h的Ramsay镇静评分量表(RSS)评分、舒适度评分(BCS)及首次肠鸣音恢复时间、首次肛门排气时间、首次排便时间比较差异均无统计学意义(P> 0. 05);两组患者初乳时间及0～24,24～48 h哺乳次数比较差异均无统计学意义(P> 0. 05);观察组患者不良反应发生率显著低于对照组(P <0. 05)。结论耳穴埋豆、穴位贴敷镇痛方案干预二胎子宫收缩痛产妇,可有效减轻其术后切口及宫缩疼痛,促进胃肠功能恢复,增加母乳量,效果与镇痛泵持平,可替代镇痛泵,减少产妇术后恶心呕吐等不良反应,提高疗效安全性。

Objective To explore the application effect of ear - point bean - embedding, acupoint sticking and analgesia pump in postpartum uterine contraction pain of second pregnancy. Methods To compare the status of postoperative pain, analgesic effect, comfort, gastrointestinal recovery, lactation and breastfeeding result, and adverse reactions, 150 cases of women with second pregnancy who underwent cesarean section were observed, and randondy divided into control group and study group with equal members. The control group received patient controlled intravenous analgesia（PCIA） analgesic treatment, while the study group received analgesia treatment for earpoint bean - embedding combined with acupoint sticking. Results The visual analogue scale（VAS） scores of incision pain and uterine contraction pain in 2h （T1）, 6h （T2）, 24h （T3） after operation were significantly increased in both groups （P 〈 0.05 ）, and there were differences of statistical significance between the two groups at different time points （P 〈 0.05 ）, but no difference of sta- tistical significance between groups（P 〉 0.05）. The differences in Ramsay sedation scale（RSS）, Bruggrmann comfort scale（BCS） and time of first bowel sound recovery, time of first anal exhaust, and time of first defecation between the two groups was not statistically significant at 24h after operation （ P 〉 0.05 ）. The difference in colostrums time and the number of breastfeeding at intervals of 0 -24h and 24 -48 h between the two groups had no statistical significance （ P 〉 0.05 ）. The incidence of adverse reactions in the study group was significantly lower than that in the control group （ P 〈 0.05 ）. Conclusion The ap- plication of ear - point bean - embedding and acupoint sticking for analgesia on postpartum uterine contraction pain in women with second pregnancy could effectively reduce incision pain and uterine contraction pain after operation, promote the recovery of gastrointestinal function, increase the amount of breast milk, which was parallel to nalgesia pump treatment and could be used as a alternative intervention to reduce adverse reactions such as postpartum nausea and vonfiting and improve the safety of treatment efficacy.