揿针对妊娠合并乙型肝炎产妇剖宫产术后宫缩痛的镇痛效果观察

Analgesic Effect of Press Acupuncture on Uterine Contraction Pain After Cesarean Section in Pregnant Patients with Hepatitis B

目的探讨揿针疗法对妊娠合并乙型肝炎产妇剖宫产术后宫缩痛镇痛效果的影响。方法选取2022年10月至2023年10月上海市公共卫生临床中心收治的剖宫产术后宫缩痛合并乙型肝炎感染的产妇80例作为研究对象,按照随机数字表法分为试验组和对照组,每组40例。对照组采用常规处理措施,试验组在对照组基础上应用揿针疗法。分别采用视觉模拟评分法(VAS)和自觉疼痛评估表评估两组产妇术后宫缩痛、切口疼痛情况及术后24 h内镇痛效果;采用镇静评分量表(Ramsay评分)评估两组产妇镇静状态;采用舒适评分(BCS)和自拟满意度评价表分别评价两组产妇舒适度及对治疗的满意度。比较两组产妇术后48 h内不良反应发生情况及肝功能Child分级情况。结果试验组术后2~24 h镇痛优良级占比高于对照组(P<0.05)。两组术后24 h切口疼痛及宫缩痛VAS评分均高于术后6 h(P<0.05);试验组术后6 h和24 h切口疼痛及宫缩痛VAS评分均低于对照组(P<0.05)。试验组干预后不同时间段Ramsay评分均高于对照组,24 h BCS评分和满意度评分均高于对照组(P<0.05)。两组不良反应发生率及肝功能Child分级比较,差异均无统计学意义(P>0.05)。结论揿针疗法能减轻妊娠合并乙型肝炎产妇剖宫产术后切口疼痛、宫缩痛,发挥良好的镇痛效果,且操作简便,安全性较好。

Objective To explore the effect of press acupuncture on relieving pain caused by uterine contraction after cesarean section in pregnant women with hepatitis B.Methods A total of 80 pregnant women with hepatitis B infection and uterine contraction pain after cesarean section in Shanghai Public Health Clinical Center from October 2022 to October 2023 were selected as the research objects.They were randomly divided into an experimental group(n=40)and a control group(n=40).The control group was treated with conventional treatment,while the experimental group was additionally given press acupuncture on the basis of conventional treatment.The incision pain and uterine contraction pain[assessed by Visual Analog Scale(VAS)],analgesic effect within 24 h after surgery cassessed by self-perceived pain assessment form,sedation status[assessed by Ramsay Sedation Scale(RSS)],comfort[assessed by Bruggrmann Comfort Scale(BCS)],and satisfaction[assessed by self-designed satisfaction evaluation table]were compared between the two groups.The incidence of adverse reactions within 48 h after surgery,as well as the Child-Pugh classification of liver function were compared between the two groups.Results The proportion of excellent analgesic effect in the experimental group was better than that in the control group within 2-24 h after surgery(P<0.05).The VAS scores for incision pain and uterine contraction pain at 24 h after surgery were higher than those at 6 h after surgery in both groups(P<0.05).And compared with the control group,the experimental group showed lower VAS scores for incision pain and uterine contraction pain at 6 h and 24 h after surgery(P<0.05).The RSS score in the experimental group was lower than that in the control group at various time points after intervention(P<0.05).And the scores of BCS and satisfaction in the experimental group were higher than those in the control group at 24 h after surgery(P>0.05).There was no statistically significant difference in the incidence of adverse reactions and Child-Pugh classification between the two groups(P<0.05).Conclusion Press acupuncture can further reduce the pain of incision and uterine contraction,indicating good analgesic effect.It is easy to operate and has good safety.