安神药枕联合耳穴压豆干预对全身麻醉下脊柱术后患者睡眠障碍的效果观察

Observation on Effect of Medicine Pillow Combined with Ear Acupoint Pressing Beans on Sleep Disturbance in Patients after Spinal Surgery Under General Anesthesia

目的探究运用安神药枕联合耳穴压豆干预全身麻醉下脊柱术后患者睡眠障碍(失眠)的效果。方法将200例脊柱骨科术后患者随机分为耳穴组(70例)、药枕组(70例)、耳穴+药枕联合组(60例)。三组患者均给予常规术后失眠干预措施,在此基础上,耳穴组给予王不留行籽贴单耳,药枕组予中药安神药枕放于枕后,联合组为耳穴+药枕联合治疗,分析三组患者的术前、术后当天、术后1天、术后3天匹兹堡睡眠质量指数量表(PSQI)、汉密尔顿焦虑量表(HAMA)评分以及三组的视觉模拟评分量表(VAS)及镇静评分(Ramsay)比较。结果各组患者PSQI评分、HAMA评分以及VAS和Ramsay评分呈现先上升后下降的趋势,其中手术后当天评分最高,术后1天开始下降,术后3天评分明显低于术后当天。术后3天联合组PSQI评分优于其他两组(P<0.05)。术后3天,联合组与耳穴组、药枕组比较,HAMA评分无统计学意义(P>0.05)。术后3天三组的VAS和Ramsay评分均下降,安神组和耳穴组的VAS和Ramsay评分比较无明显差异(P>0.05),联合组评分均明显低于其他两组(P<0.05)。结论运用两种中医护理技术,安神药枕配合耳穴压豆能有效改善全身麻醉下脊柱术后患者不良情绪及睡眠质量,缓解其疼痛,有利于术后快速康复,值得临床推广与应用。

Objective To explore the effect of using medicine pillow combined with ear acupoint pressing beans on sleep disturbance(insomnia)in patients after spinal surgery under general anesthesia.Methods A total of 200 patients after spinal surgery were randomly divided into auricular point group(70 cases),medicine pillow group(70 cases),auricular point+medicine pillow combination group(60 cases).The three groups were all given routine postoperative insomnia intervention measures.On this basis,the auricular point group was given Wangbuliuxing(Vaccariae Semen)seed patch for single ear,the medicine pillow group was given Chinese medicine medicine pillow and the combination group was combined auricular point+medicine pillow.After treatment,the scores of Pittsburgh Sleep Quality Index(PSQI),Hamilton Anxiety Scale(HAMA)and the postoperative visual analog scale(VAS)and sedation score(Ramsay)of the three groups of patients were analyzed before surgery,on the day after surgery,on the 1 st and the 3 rd day after surgery.comparison.Results The PSQI scores,HAMA scores,VAS and Ramsay scores of patients in each group showed a trend of increasing first and then decreasing.The scores on the day after surgery were the highest,and began to decrease on the day after surgery.The scores on the third day after surgery were significantly lower than those on the day after surgery.Three days after operation,the PSQI score of the combined group was better than that of the other two groups(P<0.05).Three days after the operation,there was no significant difference in the HAMA score among the combination group,the auricular point group and the medicine pillow group(P>0.05).Three days after the operation,there was no significant difference in the VAS or Ramsay scores between the combination group and the auricular point group(P>0.05),and the scores in the combination group were significantly lower than those in the other two groups(P<0.05).Conclusion Using two kinds of traditional Chinese medicine nursing techniques,medicine pillow combined with ear acupoint pressing beans can effectively improve the bad mood and sleep quality of patients after spinal surgery under general anesthesia,relieve their pain,and facilitate rapid postoperative recovery,which is worthy of clinical promotion and application.