内关-外关透刺针法预防剖宫产术中仰卧位低血压综合征的效果

Effect of piercing needling technique from Neiguan to Waiguan to prevent supine hypotensive syndrome during cesarean section

目的评估内关-外关透刺针法预防剖宫产术中仰卧位低血压综合征(SHS)的疗效。方法选择择期拟在腰-硬联合麻醉下行剖宫产产妇78例,年龄21~44岁,BMI 21.5~35.5 kg/m^(2),ASAⅠ或Ⅱ级。随机分为两组:针刺组(n=38)和对照组(n=40)。针刺组在麻醉操作前,右侧内关透外关留针10 min,麻醉操作后左侧内关透外关留针30 min。对照组不予针刺操作。SHS定义为SBP<90 mmHg,且至少伴有恶心、呕吐、胸闷、头晕症状之一。记录胎儿娩出前SHS发生情况,记录胎儿娩出前低血压、恶心、呕吐、胸闷和头晕的发生情况,记录术中多巴胺用量和产妇满意例数。结果与对照组比较,针刺组术中SHS发生率、低血压、恶心、呕吐、胸闷、头晕的发生率明显降低(P<0.05),多巴胺用量明显减少(P<0.05),产妇满意率明显升高(P<0.05)。结论双侧内关-外关透刺针法能有效降低剖宫产术中SHS及恶心、呕吐的发生率,提高产妇满意度。

Objective To evaluate the efficacy of piercing needling technique from PC6(Neiguan)to TE5(Waiguan)to prevent supine hypotensive syndrome(SHS)during cesarean section.Methods Seventy-eight parturients of ASA physical statusⅠorⅡ,aged 21-44 years,BMI 21.5-35.5 kg/m^(2),scheduled for cesarean delivery undergoing combined spinal and epidural analgesia,were randomly divided into two groups:needling group(n=38)and control group(n=40).Neiguan pierced to Waiguan,the needles were retained for 10 minutes on the right side before analgesia,and for 30 minutes on the left side after analgesia operation in the needling group.The control group was not given needles.SHS was defined SBP<90 mmHg with at least one symptom of nausea,vomiting,chest tightness and dizziness.The occurrence of SHS before fetal delivery was recorded.The incidence of hypotension,nausea,vomiting,chest tightness and dizziness were recorded.The dosage of dopamine and the maternal satisfaction were recorded.Results Compared with the control group,the incidence of SHS,the incidence of hypotension,nausea,vomiting,chest tightness and dizziness were significantly lower in the needling group(P<0.05),the dosage of dopamine was significantly lower in the needling group(P<0.05),the incidence of the maternal satisfaction was significantly higher in the needling group(P<0.05).Conclusion The piercing needling from Neiguan to Waiguan can effectively reduce the incidence of SHS,nausea,vomiting,and increase the maternal satisfaction during cesarean section.