经皮穴位刺激在妇科腹腔镜术后镇痛中的临床研究

Clinical efficacy of percutaneous acupoint stimulation on gynecological laparoscopic analgesia

目的:研究经皮穴位刺激对妇科腹腔镜术后镇痛的临床效果。方法:将我院2017年6月-2019年5月收治的行择期妇科腹腔镜手术患者共148例随机分为对照组和观察组,两组均常规全麻下行择期妇科腹腔镜手术和术后自控静脉镇痛,观察组加用经皮穴位刺激治疗。分别记录两组术后6 h、12 h、24 h、48 h、72 h视觉模拟疼痛评分(Visual Analogue Scale,VAS)、BCS舒适度评分,检测治疗前后血清皮质醇(COR)、β-内啡肽(β-EP)水平,记录自控镇痛药物剂量、补救用药剂量、首次补救镇痛时间、镇痛泵有效按压次数,记录不良反应发生率。结果:治疗72 h后,观察组术后12 h、24 h、48 h、72 h VAS评分均显著低于对照组(P<0.05),术后6 h、12 h、24 h、48 h、72 h BCS评分均显著高于对照组(P<0.05);两组术后72 h COR、β-EP均较治疗前升高(P<0.05),且观察组低于对照组(P<0.05);观察组自控镇痛药物剂量、补救用药剂量、首次补救镇痛时间、镇痛泵有效按压次数和不良反应发生率均显著低于对照组(P<0.05)。结论:经皮穴位刺激可以减轻妇科腹腔术后患者的疼痛,减轻应激反应,提高舒适度,减少不良反应和镇痛药物使用。

Objective:To study the clinical efficacy of percutaneous acupoint stimulation on gynecological laparoscopic analgesia.Methods:From June 2017 to May 2019,148 cases were randomly divided into the control group and the observation group.Both groups underwent regular general anesthesia for elective gynecologic laparoscopic surgery and surgery.After self-controlled intravenous analgesia,the observation group was treated by percutaneous acupoint stimulation.The visual analogue pain score(VAS)and BCS comfort scores were recorded at 6 h,12 h,24 h,48 h and 72 h after operation.The levels of serum cortisol(COR)andβ-endorphin(β-EP)were measured before and after treatment.The dose of self-controlled analgesic drugs,the amount of remedial medication,the time of first remedial analgesia,the number of effective compressions of an analgesic pump and the incidence of adverse reactions were recorded.Results:After 72 hours of treatment,the VAS scores in the observation group were significantly lower than those in the control group at 12 h,24 h,48 h and 72 h after operation(P<0.05).The BCS scores at 6 h,12 h,24 h,48 h and 72 h were significantly higher than those in the control group(P<0.05).COR andβ-EP were significantly higher than those before treatment(P<0.05),and those in the observation group were lower than the control group(P<0.05).Self-controlled analgesic and remedy in the observation group were observed.The time of first remedial analgesia,the number of effective presses of analgesic pumps and the incidence of adverse reactions were significantly lower than those in the control group(P<0.05).Conclusion:Percutaneous acupoint stimulation can alleviate pain in patients after gynecological abdominal surgery,reduce stress response and adverse reactions,improve comfort.