耳穴贴压对肛周脓肿患者术后疼痛、尿潴留及心理状态的影响

Effect of Auricular Point Sticking on Postoperative Pain, Urinary Retention and Psychological State of Patients with Perianal Abscess

目的:观察耳穴贴压对肛周脓肿患者术后疼痛、尿潴留及心理状态的影响。方法:将62例肛周脓肿行一期根治术患者随机分为治疗组(31例)和对照组(31例)。对照组患者术后给予常规的治疗和护理方法干预,治疗组患者在对照组基础上联合耳穴贴压治疗,两组均治疗7 d。比较两组患者首次排尿症状积分、术后尿潴留指标、术后肛门疼痛评分、术后双氯芬酸钠使用量、汉密尔顿焦虑量表评分(HAMA)、汉密尔顿抑郁量表评分(HAMD)及治疗方案安全性。结果:治疗组患者术后首次排尿困难程度、尿不尽感、尿等待时间、小腹症状积分均明显低于对照组(P<0.05);治疗组患者术后首次排尿等待时间、术后1 d残尿量、术后首次排尿时间均明显低于对照组(P<0.05),首次排尿量明显高于对照组(P<0.05);两组患者术后24 h、48 h、72 h、1周肛门疼痛评分均呈降低趋势(P<0.05),且治疗组患者术后6 h、24 h、48 h、72 h、1周肛门疼痛评分均明显低于对照组(P<0.05);两组患者术后3 d、7 d双氯芬酸钠栓使用量均明显下降(P<0.05),且治疗组患者术后1 d、3 d、7 d双氯芬酸钠栓使用量均明显低于对照组(P<0.05);两组患者术后7 d的HAMA评分和HAMD评分均明显降低(P<0.05),且治疗组患者HAMA评分和HAMD评分均明显低于对照组(P<0.05);两组患者治疗期间均未出现严重的不良反应。结论:耳穴贴压能够有效缓解肛周脓肿术后患者疼痛症状,减轻术后心理应激状态,改善术后排尿障碍,具有镇痛、抗焦虑等多重效应,且安全性较好。

Objective: To observe the effect of auricular point sticking on postoperative pain, urinary retention and psychological state of patients with perianal abscess. Methods: A total of 62 patients with perianal abscesses who underwent one-stage radical resection were randomly divided into a treatment group(31 cases) and a control group(31 cases). The control group was given routine treatment and nursing intervention after operation, and the treatment group was given auricular plaster therapy on the basis of the control group. Both groups were treated for 7 days. The first urination symptom score, postoperative urinary retention index, postoperative anal pain score, postoperative diclofenac sodium dosage, Hamilton Anxiety Scale(HAMA), Hamilton Depression Scale(HAMD) and the safety of the treatment regimen were compared between the two groups. Results: The degree of dysuria for the first time, incomplete feeling of urine, urine waiting time and abdominal symptoms in the treatment group were significantly lower than those in the control group(P<0.05). The waiting time for the first micturition,residual urine volume on the first day after operation and the first micturition time after operation in the treatment group were significantly lower than those in the control group(P<0.05), and the first micturition volume in the treatment group was significantly higher than that in the control group(P<0.05). The anal pain scores at 24 h,48 h, 72 h and 1 week after operation in the two groups showed a decreasing trend(P<0.05), and the anal pain scores at 6 h, 24 h, 48 h, 72 h and 1 week after operation in the treatment group were significantly lower than those in the control group at the same time point(P<0.05). The dosage of diclofenac sodium decreased significantly in both groups on 3 d and 7 d after operation(P <0.05), and the dosage of diclofenac sodium in the treatment group was significantly lower than that in the control group on 1 d, 3 d and 7 d after operation(P<0.05). The HAMA score and HAMD score of the two groups were significantly decreased on the 7thday after operation(P<0.05), and the HAMA score and HAMD score of the treatment group were significantly lower than those of the control group(P<0.05). There were no serious adverse reactions in the two groups. Conclusion: Auricular point sticking can effectively alleviate the pain symptoms of patients with perianal abscess after operation, reduce the postoperative psychological stress state, and improve the postoperative dysuria. It has multiple effects such as analgesia and anti anxiety, and has good safety.