摘要
目的:观察长留针电刺激法用于腹腔镜胆囊切除术(LC)术后镇痛的疗效及对术后排气时间的影响。方法:选择择期在静吸复合全身麻醉下行LC患者90例,随机分为3组,每组30例。对照组,术后无镇痛;镇痛泵组采用术后经静脉患者自控镇痛(PCIA);留针组应用电针刺激仪镇痛,术前穴取日月、气冲、阳陵泉,平刺穴位置入针灸针,用无菌贴膜固定留置,于术后8、20h给予电针刺激,疏密波型,频率2Hz/100Hz,均持续30min。观察并记录3组患者术后2、4、8、12、24、36h疼痛视觉模拟评分(VAS),呕吐、恶心等不良反应发生情况及术后排气时间。结果:术后2、4、8、12、24h各时点留针组与镇痛泵组VAS评分均低于对照组(P<0.05,P<0.01),且留针组在以上各时点的镇痛效果优于镇痛泵组(均P<0.05);留针组没有不良反应发生,而镇痛泵组出现嗜睡3例、恶心6例、呕吐3例,对照组出现恶心2例、呕吐1例;留针组排气时间明显早于其他两组[(14.77±4.99)h vs(18.50±4.22)h,P<0.01;(14.77±4.99)h vs(18.17±4.69)h,P<0.05]。结论:长留针电刺激法用于LC术后镇痛安全、有效,避免了术后应用镇痛药物的不良反应,同时可促进肛门排气。
Objective To observe the clinical effect of electric stimulation of long-term retaining needle on analgesia after laparoscopic cholecystectomy （LC） and the impacts on the post-surgical flatus time. Methods Under static absorptive composite general anesthesia, 90 cases of LC were randomized into three groups, 30 cases in each one. In the control group, the analgesia was not applied after LC. In the analgesia-pumper group, the patient con- trolled intravenous analgesia （PCIA） was used. In the needle-retaining group, the electric acupuncture stimulator was used. The needles were inserted transversely at Riyue （GB 24）, Qichong （ST 30） and Yanglingquan （GB 34） and fixed with sterile sticker. Separately, in 8 h and 24 h after surgery, the electric acupuncture stimulation with disperse-dense wave, 2 Hz/100 Hz frequency was applied continuously for 30 rain. Visual analogue scale （VAS）, adverse reactions such as vomiting and nausea and the postoperative flatus time in 2, 4, 8, 12, 24 and 36 h after surgery were observed and recorded in the three groups. Results In 2, 4, 8, 12 and 24 h after surgery, VAS scores in the needle-retaining group and the analgesia-pumper group were all lower than those in the control group （P〈0.05, P〈0.01）. The analgesia effect at the above time points in the needle-retaining group was better than that in the analgesia-pumper group （all P〈0.05）. There was not adverse reaction in the needle-retaining group. But there were 3 cases of somnolence, 6 cases of nausea and 3 cases of vomiting in the analgesia-pumper group, and 2 cases of nausea and 1 case of vomiting in the control group. The flatus time was quite earlier in the needleretaining group as compared with the other two groups [（14.77±4.99） h vs （18.50±4.22） h, P〈0.01; （14.77±4.99） h vs （18.17±4.69） h, P〈0.05]. Conclusion The electric stimulation of long-term retaining needle is safe and effective in analgesia after LC. It avoids the adverse reactions of analgesics and promotes postoperative flatus. KEY WORDS postoperative analgesia~ eleetroacupuncture~ long-term retaining needle; laparoscopic cholecystectomy
出处
《中国针灸》
CAS
CSCD
北大核心
2014年第2期169-172,共4页
Chinese Acupuncture & Moxibustion
基金
上海市中医药事业发展三年行动计划(重大研究)项目:ZYSNXD-CC-ZDYJ 014
关键词
术后镇痛
电针
长留针
腹腔镜胆囊切除术
postoperative analgesia~ eleetroacupuncture~ long-term retaining needle
laparoscopic cholecystectomy
