右美托咪定联合经皮穴位电刺激对混合痔剥扎术后患者肠胃功能及术后疼痛的影响

Effects of Dexmedetomidine Combined with Percutaneous Acupoint Electrical Stimulation on Gastrointestinal Function and Postoperative Pain in Patients with Mixed Hemorrhoid Stripping

目的:探讨右美托咪定联合经皮穴位电刺激对混合痔剥扎术后患者肠胃功能及术后疼痛的影响。方法:选择2022年3月-2022年7月我院行混合痔剥扎术的患者60例,将60例患者随机分为对照组(30例)与观察组(30例),对照组患者给予右美托咪定镇痛,观察组给予术前经皮穴位电刺激,时间为手术开始前2 min至手术结束,右美托咪定使用方法、剂量同对照组。对比两组患者术前、术后0.5 h、1 h、2 h、3 h的疼痛评分,对比两组患者的术后疼痛疗效,对比两组创面愈合时间、腐肉完全脱落时间、住院时间及胃肠功能恢复情况,对比两组术前、术后的血管活性肠肽、胃动素及胃泌素水平。结果:术前及术后3 h时,两组的疼痛评分对比无统计学意义(P>0.05);术后0.5 h、1 h、2 h时,观察组的疼痛评分明显较对照组低(P<0.05)。观察组的术后疼痛有效率明显较对照组高,P<0.05。观察组的创面愈合时间、腐肉完全脱落时间及住院时间明显较对照组低(P<0.05)。观察组的肠鸣音恢复时间、术后恶心呕吐发生率及排气时间明显较对照组短(P<0.05)。术前,两组的血管活性肠肽、胃动素及胃泌素水平对比无统计学意义(P>0.05);术后,两组血管活性肠肽、胃泌素水平升高,胃动素水平降低,且观察组变化幅度明显较对照组低(P<0.05)。结论:右美托咪定联合经皮穴位电刺激可改善混合痔剥扎术后患者肠胃功能及术后疼痛情况。

Objective:To investigate the effects of dexmedetomidine combined with percutaneous acupoint electrical stimulation on gastrointestinal function and postoperative pain of patients after mixed hemorrhoid stripping.Methods:60 patients who underwent mixed hemorrhoidectomy in our hospital from March 2022 to July 2022 were selected,and 60 patients were randomly divided into Matched group(30 cases)and observation group(30 cases).The Matched group was given dexmedetomidine analgesia,and the observation group were given preoperative percutaneous acupoint electrical stimulation,2min before the operation to the end of the operation.The method and dose of dexmedetomidine were the same as Matched group.The pain scores of patients in two groups were compared before and after 0.5 h,1 h,2 h and 3 h,the postoperative pain efficacy of patients in two groups were compared,the wound healing time,the time of rotting flesh completely shedding,the length of hospital stay and the recovery of gastrointestinal function of the two groups were compared,and the levels of vasoactive intestinal peptide,motilin and gastrin in the two groups were compared before and after surgery.Results:There were no difference in pain scores in two groups before and 3 h after surgery(P>0.05);after surgery for 0.5 h,1 h and 2 h,the pain score of the observation group was lower than that of the matched group(P<0.05).The effective rate of postoperative pain in the observation group was higher than the matched group(P<0.05).Compared with Matched group,the wound healing time,carrion shedding time and hospital stay time of the observation group were lower(P<0.05).The recovery time of bowel sounds,incidence of postoperative nausea and vomiting and exhaust time in the observation group were shorter than those in the matched group(P<0.05).Before surgery,there was no difference in the levels of vasoactive intestinal peptide,motilin and gastrin in two groups(P>0.05).After surgery,the levels of vasoactive intestinal peptide and gastrin in both groups increased,while the levels of motilin decreased,and the range of change in observation group was lower than that in matched group(P<0.05).Conclusion:Dexmedetomidine combined with percutaneous acupoint electrical stimulation can improve gastrointestinal function and postoperative pain in patients with mixed hemorrhoid dissection.