| 熊畅,韩成鹏,赵栋,彭文勇,许多嘉,蓝志坚.针刺联合低呼气末二氧化碳对妇科腔镜手术患者术后恶心呕吐的影响[J].浙江中西医结合杂志,2022,32(2): |
| 针刺联合低呼气末二氧化碳对妇科腔镜手术患者术后恶心呕吐的影响 |
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| 投稿时间：2021-04-17 修订日期：2021-07-28 |
| DOI： |
| 中文关键词: 针刺 呼气末二氧化碳 腹腔镜手术 术后恶心呕吐 |
| 英文关键词:Acupuncture low end-tidal carbon dioxide laparoscopic surgery postoperative nausea and vomiting |
| 基金项目:金华市科学技术研究计划项目(No:2021-4-004) |
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| 中文摘要: |
| 目的:探索针刺与低呼气末二氧化碳(LEtCO2)两种非药物疗法的联合对妇科腔镜手术患者术后恶心呕吐(PONV)的影响。方法 择期行妇科腔镜手术患者90例,按随机数字表法分为3组(每组30例)：即单纯止吐药物托烷司琼处理组(T组)、单纯针刺内关穴组(A组)以及针刺内关穴联合LEtCO2组(A+LEtCO2组)。观察并记录术后24h内各组患者PONV发生人数、补救止吐人数以及 PONV严重程度分级情况；记录麻醉诱导前(T0)、气管插管后(T1)、手术开始后30min(T2)、Trendelenburg(TP)体位复位前(T3)以及TP体位复位后5 min(T4)的局部脑氧饱和度(rSO2)；记录各组患者术后2h(T5)、4h(T6)、12h(T7)以及24h(T8)静息状态下视觉模拟评分(VAS)。结果 与T组和A组比较,A+LEtCO2组患者术后24h PONV发生率、止吐药补救使用人数以及PONV严重程度显著下降(P<0.05)；在T3、T4以及T5时间点,A+LEtCO2组rSO2较T组和A组显著降低(P<0.05)；3组患者术后各时间点VAS无显著差异；T组与A组比较各指标均无统计学差异。结论 针刺联合LEtCO2对于妇科腔镜手术患者PONV有较好的预防效果和治疗效果。 |
| 英文摘要: |
| Objective To explore the effect of acupuncture combined with low end-tidal carbon dioxide (LEtCO2) on PONV in patients undergoing gynaecological laparoscopic surgery. Methods Ninety patients undergoing elective gynaecological laparoscopic surgery were divided into 3 groups (30 cases in each group) according to the random number table: the simple antiemetic drug tropisetron treatment group (T group), the simple acupuncture at Neiguan point group (A group) and acupuncture at Neiguan point combined with LEtCO2 group (A+LEtCO2 group). The incidence of PONV, the number of remedial antiemetic patients and the severity of PONV in each group within 24 hours after surgery observed and recorded. Record the regional cerebral oxygen saturation (rSO2) before induction of anesthesia (T0), after tracheal intubation (T1), 30 minutes after surgery (T2), Trendelenburg (TP) position before reduction (T3), and 5 minutes after TP position reduction (T4); The visual analogue scale (VAS) scores at resting state at 2h (T5), 4h (T6), 12h (T7) and 24h (T8) after surgery were recorded. Results Compared with group T and group A, the incidence of PONV, the number of remedial antiemetic patients and the severity of PONV in group A+LEtCO2 were significantly decreased (P<0.05); At T3, T4 and T5 time points, rSO2 in the A+LEtCO2 group was significantly lower than that in the T and A groups (P<0.05); There was no significant difference in VAS at each postoperative time point between the 3 groups (P＞0.05). And no significant difference was found in all indicators between group T and group A. Conclusion Acupuncture combined with LEtCO2 has better preventive and therapeutic effects for PONV in patients undergoing gynecological laparoscopic surgery. |
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