摘要
目的 探讨脚踝针结合择时耳穴压丸用于胸外科术后镇痛效果.方法 前瞻性选取 2020 年 1 月—2022 年12 月收治的胸外科术后患者130 例,采用随机数字表法分为3 组,A组44 例采取脚踝针结合择时耳穴压丸,B组43 例采取脚踝针,C组43 例采取择时耳穴压丸.比较3 组视觉模拟评分法(VAS)评分、静脉自控镇痛(PCIA)给药次数、疼痛介质[5-羟色胺(5-HT)、前列腺素E2(PGE2)、β-内啡肽(β-EP)]、呼吸功能指标[动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、氧合指数(OI)]、匹兹堡睡眠质量指数(PSQI)评分、医院焦虑抑郁量表(HAD)评分、不良事件发生率及舒适度.结果 术后3、7d,A组静息和活动状态VAS评分、PaCO2 及血清5-HT、PGE2 水平低于B组、C组,PaO2、OI、β-EP高于B组、C组(P＜0.05).术后7d,A组PSQI、HAD评分均低于B组、C组(P＜0.05).A组舒适度优于B组、C组,PCIA给药次数少于B组、C组(P＜0.05).B组与C组舒适度和PCIA给药次数比较差异均无统计学意义(P＞0.05).3 组不良事件发生率比较差异无统计学意义(P＞0.05).结论 脚踝针结合择时耳穴压丸用于胸外科术后镇痛效果确切,可减轻负面情绪,提高舒适度,改善睡眠及呼吸功能,可能与调节疼痛介质有关.
Abstract
Objective To explore the analgesic effect of ankle acupuncture combined with timing ear acupoint press-ing pills for postoperative thoracic surgery.Methods A prospective selection of 130 patients receiving thoracic surgery admit-ted from January 2020 to December 2022 was conducted.They were divided into three groups using a random number table method.Group A consisted of 44 patients who received ankle acupuncture combined with timing ear acupoint pressing pills,group B consisted of 43 patients who received ankle acupuncture,and group C consisted of 43 patients who received timing ear acupoint pressing pills.Visual analogue scale(VAS)scores,number of patient-controlled intravenous analgesia(PCIA)compression,and pain mediators[5-hydroxytryptamine(5-HT),prostaglandin E2(PGE2),β-Endorphin(β-EP)],respira-tory function indicators[arterial oxygen pressure(PaO2),arterial carbon dioxide pressure(PaCO2),oxygenation index(OI)],Pittsburgh Sleep Quality Index(PSQI)score,Hospital Anxiety and Depression Scale(HAD)score,incidence of ad-verse events,and comfort level were compared among the three groups.Results At 3 and 7 d after surgery,VAS scores at rest and movement,PaCO2,serum 5-HT,and PGE2 levels were lower in group A than in group B and group C,while PaO2,OI,and β-EP were higher than those of group B and group C(P＜0.05).At 7 d after surgery,the PSQI and HAD scores of group A were lower than those of group B and group C(P＜0.05).The comfort level of group A was better than that of group B and group C,while the number of PCIA administration was less than that of group B and group C(P＜0.05).There was no statistically significant difference in comfort level and the number of PCIA administration between group B and group C(P＞0.05).There was no statistically significant difference in the incidence of adverse events among the three groups(P＞0.05).Conclusion The combination of ankle acupuncture and timing ear acupoint pressure pills has a definite analgesic effect after thoracic surgery.It can alleviate negative emotions,enhance comfort,and improve sleep and respiratory function,and the mechanism may be related to regulation of pain mediators.
维普
万方数据