耳穴联合腕踝针结合常规护理干预对髋关节置换术后疼痛的影响

The Effect on Pain of Auricular Acupoint Combined With Wrist-Ankle Needle and Routine Nursing in After Hip A rthroplasty

目的:探讨耳穴联合腕踝针结合常规疼痛护理干预对髋关节置换术后疼痛的影响。方法:选择118例人工髋关节置换术的髋关节炎患者,采用便利抽样法分为观察组60例和对照组58例。所有患者术后采用自控静脉镇痛,对照组给予常规疼痛护理干预方法,观察组在对照组护理的基础上给予耳穴联合腕踝针疼痛干预,观察2组治疗前后VAS评分,自控静脉药物用量,血清肿瘤坏死因子(TNF-α)及白细胞介素6(IL-6)水平及髋关节Harris评分。结果:2组术前1d的VAS评分比较,差异无统计学意义(P>0.05),观察组术后3d、7d及14d的VAS评分都显著低于对照组(P<0.05)。2组患者术后1~3d的自控静脉镇痛药物用量比较差异无统计学意义,2组均未出现追加镇痛药物情况(P>0.05)。2组术前1d的血清TNF-α与IL-6含量比较差异无统计学意义(P>0.05),观察组术后3d、7d及14d的血清TNF-α与IL-6含量均低于对照组(P<0.05),但是都高于术前1d(P<0.05).观察组与对照组术后3个月的髋关节Harris评分都显著高于术前ld(P<0.05),观察组也显著高于对照组(P<0.05).结论:耳穴联合腕踝针结合常规疼痛护理干预在髋关节置换术后的应用能发挥更有效的疼痛控制,抑制血清TNF-α与IL-6的释放,且不会增加自控静脉镇痛药物用量,从而促进髋关节功能的改善。

Objective:To explore the effects of auricular point combined with wrist ankle acupuncture combined with conventional pain nursing intervention on pain intervention after hip replacement.Methods:Used a convenience sampling and retrospective study method.From June 2013 to February 2017,118 patients with hip joint arthroplasty in our hospital were selected as the subjects.All the patients were divided into the observation group(60 patients)and the control group(58 patients)accorded to the different analgesic methods.All patients were given postoperative self controlled intravenous analgesia,the control group was given conventional pain nursing intervention,the observation group was given auricular points combined with wrist ankle acupuncture pain intervention based on the nursing in the control group,and the prognosis of the two groups were recorded.Results:There was no significant difference in the preoperative VAS scores compared between the two groups(P>0.05).The postoperative 3d,7d and 14d VAS scores in the observation group were significantly lower than those in the control group(P<0.05).There were no significant difference in the dosage of the postoperative 1-3d self control led intravenous analgesia,and there were no additional analgesic drugs were found in the two groups(P>0.05).There were no significant difference in preoperative serum 1d TNF-α and IL-6 compared between the two group(P>0.05).The postoperative 3d,7d and 14d levels of serum TNF-a and IL-6 in the observation group were lower than those in the control group(P<0.05),and those were all higher than those in preoperative.The postoperative 3 months of Harris scores of the hip joint in the observation group and the control group were significantly higher than that of the preoperative 1d(P<0.05),and the observation group was also significantly higher than the control group(P<0.05).Conclusion:The auricular point combined wi th wrist ankle acupuncture and conventional pain nursing intervention can play a more effective pain intervention after hip replacement,it can suppress of serum TNF-α and IL-6 release,and will not increase self control led intravenous analgesia drug dosage,so as to promote the improvement of the function of hip joint.