揿针配合雷莫司琼预防妇科腹腔镜术后恶心呕吐的临床研究

Clinical Study of Intradermal Needling plus Ramosetron for Preventing Nausea and Vomiting after Gynecologic Laparoscopy

目的观察揿针配合雷莫司琼预防妇科腹腔镜手术术后恶心呕吐的临床疗效。方法将120例行妇科腹腔镜手术患者随机分为治疗组和对照组,每组60例。两组均采用丙泊酚复合瑞芬太尼静脉维持麻醉。术前15min,治疗组给予双侧足三里、内关穴贴揿针配合静脉注射雷莫司琼0.3mg治疗;对照组采用双侧相同穴位放置假治疗贴配合静脉注射雷莫司琼0.3mg治疗。观察两组患者在术后第1天和第2天的恶心呕吐发生情况。结果两组术后第1天恶心呕吐发生率比较,差异具有统计学意义(P<0.05);而两组术后第2天恶心呕吐发生率比较,差异则无统计学意义(P>0.05),且无不良并发症。结论揿针配合雷莫司琼用于预防妇科腹腔镜手术术后恶心呕吐的效果优于单用雷莫司琼,有利于促进患者康复。

Objective To observe the clinical efficacy of intradermal needling plus ramosetron in preventing postoperative nausea and vomiting(PONV)after gynecologic laparoscopy.Method A total of 120 patients who were going to receive gynecologic laparoscopy were randomized into a treatment group and a control group,with 60 cases in each group.The two groups both received intravenous propofol plus remifentanil for anesthesia.At 15 min prior to the operation,the treatment group received intradermal needling at bilateral Zusanli(ST36)and Neiguan(PC6)plus intravenous injection of ramosetron 0.3 mg;the control group received plasters at the same acupoints for sham needling treatment plus intravenous injection of ramosetron 0.3 mg.The occurrence of nausea and vomiting at the first and second days after the operation in the two groups were observed.Result There was a significant between-group difference in the occurrence rate of nausea and vomiting at the first day after the operation(P<0.05);the between-group difference in the occurrence rate of nausea and vomiting at the second day after the operation was statistically insignificant(P>0.05).There were no severe complications.Conclusion Intradermal needling plus ramosetron can produce more significant efficacy in preventing POVN after gynecologic laparoscopy compared with ramosetron alone,and it helps to promote the recovery.