足三里穴位注射盐酸地塞米松对妇科腹腔镜手术全麻术后恶心呕吐的预防作用分析

Preventive effect of Zusanli acupoint injection with dexamethasone on nausea and vomiting after gynecological laparoscopic surgery under general anesthesia

目的探究足三里穴位注射盐酸地塞米松对妇科腹腔镜手术全麻术后恶心呕吐的预防作用。方法选取2021年1月至2022年3月太和县人民医院收治的78例拟行妇科腹腔镜手术的患者作为研究对象,采用随机数字表法将其分为研究组和对照组,每组均39例。对照组术前常规静脉注射盐酸昂丹司琼4 mg,研究组在对照组基础上,联合盐酸地塞米松5 mg注射于足三里穴位。记录2组患者围手术期心率、平均动脉压(MAP)、血氧饱和度(SpO_(2))及手术时间,比较2组患者术后胃动素、血管活性肠肽水平及恶心、呕吐、常规不良反应发生率。结果2组患者手术前、后48 h心率、MAP、SpO_(2)水平及手术时间比较差异均无统计学意义(P>0.05)。研究组术后24 h内恶心、呕吐发生率低于对照组。研究组术后胃动素、血管活性肠肽水平低于对照组(P<0.05),对照组术后胃动素、血管活性肠肽水平高于术前(P<0.05)。2组患者术后乏力、头痛等常规不良反应总发生率比较,差异无统计学意义(P>0.05)。结论足三里穴位注射盐酸地塞米松应用于妇科腹腔镜手术中,有助于稳定患者胃动素、血管活性肠肽水平,降低术后恶心、呕吐发生率。

Objective To explore the preventive effect of dexamethasone hydrochloride injection at Zusanli acupoint on nausea and vomiting after gynecological laparoscopic surgery under general anesthesia.Methods Between January 2021 and March 2022,78 patients scheduled for gynecological laparoscopic surgery were randomly divided into study group and control group with 39 cases in each group.Ondansetron(4 mg)was intravenously injected in both groups before surgery,and dexamethasone(5 mg)was injected additionally at Zusanli acupoint in the study group.The perioperative heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation(SpO_(2))and operation time of the two groups were recorded.The levels of motilin and vasoactive intestinal peptide and the incidences of nausea,vomiting and routine adverse reactions were compared between the two groups.Results There was no significant difference in HR,MAP,SpO_(2)or operation time between the two groups before and 48 h after operation(P>0.05).The incidences of nausea and vomiting in the study group were lower than those in the control group 24 h after operation.Postoperative motilin and vasoactive intestinal peptide levels in the study group were lower than those in the control group(P<0.05).Postoperative motilin and vasoactive intestinal peptide levels in the control group were higher than those before operation(P<0.05).There was no significant difference in the total incidences of routine adverse reactions such as fatigue or headache between the two groups(P>0.05).Conclusion Dexamethasone hydrochloride injection at Zusanli acupoint is helpful to stabilize the motilin and vasoactive intestinal peptide levels and significantly reduce the incidences of postoperative nausea and vomiting.