穴位贴敷预防肛肠外科术后恶心呕吐护理研究

Nursing Study of Point Application on Nausea and Vomiting After Anorectal Surgery

目的:观察穴位贴敷防治肛肠外科术后恶心呕吐的护理疗效。方法:将择期进行肛肠外科手术的102例患者[美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级]随机分为2组,治疗组和对照组各51例。治疗组给予吴茱萸加生姜汁穴位贴敷,对照组给予安慰剂穴位贴敷,同时根据世界卫生组织术后恶心呕吐反应分级标准选用甲氧氯普胺进行止呕。分别记录2组在术后6 h、6~24 h、24~48 h恶心呕吐发生情况及甲氧氯普胺使用例数。结果:术后6 h和6~24 h,治疗组恶心呕吐发生率均低于对照组,差异有统计学意义(P<0.05);术后24~48 h,2组恶心呕吐发生率对比,差异无统计学意义(P>0.05)。术后6 h、6~24 h,治疗组恶心呕吐程度积分低于对照组,差异有统计学意义(P<0.05);术后24~48 h,2组恶心呕吐程度积分比较,差异无统计学意义(P>0.05)。术后6 h治疗组甲氧氯普胺使用率低于对照组,差异有统计学意义(P<0.05);术后6~24 h、24~48 h 2组甲氧氯普胺使用率比较,差异无统计学意义(P>0.05)。结论:中药穴位贴敷治疗能够改善肛肠外科患者术后恶心呕吐的发生率及恶心呕吐程度,并能降低甲氧氯普胺使用率。

Objective:To observe the nursing effect of point application on prevention and treatment of nausea and vomiting after anorectal surgery. Methods:A total of 102 cases of patients undergoing selective anorectal surgery were randomly divided into the treatment group and the control group according to grade Ⅰ ~ Ⅱ in American Society of Anesthesiologists(ASA), 51 cases in each group. The treatment group was given point application with fructus evodiae combined with succus rhizomatis zingiberis, and the control group was given point application with placebo. At the same time,metoclopramide was selected to stop vomiting according to the grading of postoperative nausea and vomiting by World Health Organization standard. The incidences of nausea and vomiting at 6 hours, 6 to 24 hours, and 24 to 48 hours after surgery and the times of metoclopramide use in the two groups were recorded. Results:At 6 hours and 6 to 24 hours after surgery, the incidences of nausea and vomiting in the treatment group were lower than those in the control group, the difference being significant(P<0.05);at 24 to 48 hours after surgery,there was no significant difference being found in the comparison of the incidences of nausea and vomiting between the two groups(P>0.05). At 6 hours and 6 to 24 hours after surgery,the scores of nausea and vomiting in the treatment group were lower than those in the control group,the difference being significant(P<0.05);at 24 to 48 hours after surgery,there was no significant difference being found in the comparison of the scores of nausea and vomiting between the two groups(P>0.05). At 6 hours after surgery, the usage rate of metoclopramide in the treatment group was lower than that in the control group,the difference being significant(P<0.05);at6 to 24 hours and 24 to 48 hours after surgery,there was no significant difference being found in the comparison of the usage rate of metoclopramide between the two groups(P>0.05). Conclusion:Point application with Chinese herbal medicine can improve the incidence and degree of postoperative nausea and vomiting in patients undergoing anorectal surgery,and reduce the usage rate of metoclopramide.