经皮电刺激不同耳穴对剖宫产术恶心呕吐发生率影响的比较

目的 比较经皮电刺激耳神门穴与眼点穴对剖宫产产妇恶心及呕吐发生率的影响.方法 将160例择期剖宫产产妇随机分为经皮电刺激耳神门穴组(A组)和经皮电刺激耳眼穴组(B组),每组80例.A组产妇入手术室后经皮电刺激耳神门穴,频率为1.5 Hz,强度由产妇自控,30 min后进行腰-硬联合麻醉,术中持续刺激至术后2 h;B组电刺激耳眼穴,操作方法同A组.观察时间分别为开始麻醉至剖出胎儿(T1)、剖出胎儿至缝合子宫完毕(T2)、探查腹腔至缝合皮肤切口(T3)、硬膜外腔给予吗啡至术后2 h(T4).观察项目分别为①恶心及呕吐发生率,低血压、低心率发生率;②胃复安、缩宫素、麻黄碱、阿托品使用率;③新生儿Apgar评分及出血量.结果 A组较B组在T3、T4时间段的恶心及呕吐发生率降低(P＜0.05),在T1、T2时间段两组无差异(P＞0.05);A组较B组术中胃复安使用率降低(P＜0.01);两组低血压、低心率发生率、缩宫素、麻黄碱、阿托品使用率,术中出血量及新生儿Apgar评分无差异(P＞0.05).结论 经皮电刺激耳神门穴较眼穴具有更为明显的抗恶心呕吐作用.

Comparison of the Effects of Transcutaneous Electrical Stimulation of Different Auricular Points on Cesarean Section-iuduced Nausea and Vomitinglncidence

Objective To compare the effects of transcutaneous electrical stimulation of auricular points Shenmen and Eye on nausea and vomiting incidence in parturients undergoing cesarean section. Methods One hundred and sixty parturients for elective cesarean section were randomly allocated to a transcutaneous electrical stimulation of auricular point Shenmen group （group A） and a transcutaneous electrical stimulation of auricular point Eye group （group B）, 80 cases each. In group A parturients after being sent into the operating room, transcutaneous electrical stimulation of auricular point Shenmen was performed at a frequency of 1.5 Hz and an intensity controlled by the parturient, lumbar epidural anesthesia was carried out 30 min later and the stimulation continued during the operation and until 2 hrs after the end of it. In group A, electrical stimulation of auricular point Eye was performed and the procedure was the same as in group A. The observation times were from the beginning of anesthesia to the delivery of a fetus through caesarean incision （T1）, from the delivery of a fetus to the completion of uterine suture （T2）, from abdominal exploration to dermal incision suture （T3） and from peridural administration of morphine to 2 hrs after the operation （T4）. The observation items were 1） nausea, vomiting, hypotension and low heart rate incidences; 2） the usage rates of metoclopramide, oxytocin, ephedrine and atropine; 3） the Apgar score for newborns and amount of bleeding. Results Nausea and vomiting incidence was lower during T3 and T4 periods in group A than in group B （P〈0.05）. There was no statistically significant difference during T1 and T2 periods between the two groups （P〉0.05）. The usage rate of metoclopramide was lower in group A than in group B （P〈0.01）. There were no statistically significant differences in low heart rate incidence and the usage rates of oxytocin, ephedrine and atropine between the two groups （P 〉0.05）. Conclusion Transcutaneous electrical stimulation of auricular point Shenmen has a more marked relieving effect on nausea and vomiting.