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肛俞穴位麻醉在肛瘘手术中的应用

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目的 观察肛俞穴位麻醉在肛瘘手术中的应用效果.方法 将我院120例肛瘘手术患者依照麻醉方式的不同,将采用中医肛俞穴位麻醉的患者62例纳入肛俞穴位麻醉组,将采用常规局部浸润麻醉的患者58例纳入对照组,比较两组麻醉效果、血流动力学指标、肛门松弛度、术中牵拉反应分级、术后疼痛视觉模拟评分法(VAS)评分、不良反应.结果 两组麻醉优良率比较差异无统计学意义(P>0.05);肛俞穴位麻醉组手术开始后10 min、术毕动脉压(MAP)和心率(HR)水平低于对照组(P<0.05);两组术中牵拉反应分级情况比较差异无统计学意义(P>0.05);肛俞穴位麻醉组肛门松弛度优于对照组(P<0.05);肛俞穴位麻醉组术后2 h、6h VAS评分低于对照组(P<0.05);两组术后12 h、24 h、48 h VAS评分比较无统计学差异(P>0.05);两组不良反应发生情况比较无统计学差异(P>0.05).结论 相较于常规浸润麻醉,中医肛俞穴位麻醉可更好地维持患者术中血流动力学的稳定,肌松效果较佳,作用时间较长,术后镇痛优势明显,不增加不良反应,不影响患者排尿功能,效果显著,安全性较高.
Application effect of Gangyu acupoint anesthesia in anal fistula surgery
Objective To observe the application effect of Gangyu acupoint anesthesia in anal fistula surgery.Methods A total of 120 patients who underwent anal fistula surgery were dinvided into two groups according to different anesthesia methods,62 patients undergoing Gangyu acupoint anesthesia were included in group A,while 58 patients undergoing routine local infiltration anesthesia were included in group B.The anesthesia effect,hemodynamics indexes,anal relaxation,intraoperative traction grading,postoperative score of Visual Analogue Scale(VAS)and adverse reactions were compared between the two groups.Results There was no significant difference in good rate of anesthesia between the two groups(P>0.05).At 10 minutes after the start of surgery and after surgery,levels of mean arterial pressure(MAP)and heart rate(HR)in group A were lower than those in group B(P<0.05);there was no significant difference in intraoperative traction grading between the two groups(P>0.05);anal relaxation in group A was better than that in group B(P<0.05);at 2 h and 6 h after surgery,VAS scores in group A were lower than those in group B(P<0.05);at 12 h and 48 h after surgery,there was no significant difference in VAS score between the two groups(P>0.05);there was no significant difference in incidence of advrese reactions between the two groups(P>0.05).Conclusion Compared with routine infiltration anesthesia,TCM Gangyu acupoint anesthesia can better maintain the stability of intraoperative hemodynamics,with better muscle relaxation effect,longer action time and significant advantages of postoperative analgesia,which will not increase adverse reactions and affect urination function,with significant effects and high safety.

Anal fistula surgeryGangyu acupoint anesthesiaApplication effectHemodynamicsPostoperative pain

赵建奎、闫晓东、祁富军

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空军军医大学第二附属医院,陕西西安 710038

肛瘘手术 肛俞穴位麻醉 应用效果 血流动力学 术后疼痛

陕西省自然科学基础研究计划

2019JM-265

2024

湖北中医药大学学报
湖北中医药大学

湖北中医药大学学报

CSTPCD
影响因子:0.873
ISSN:1008-987X
年,卷(期):2024.26(1)
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