针刺对腹腔镜术后恶心、呕吐的预防作用

目的:探讨围术期针刺内关穴减少腹腔镜胃肠手术术后恶心、呕吐的效果.方法:选取择期行腹腔镜胃肠手术患者100例,双盲随机分为针刺组和对照组,每组50例.两组均采用静吸复合全麻,术后患者均行静脉自控镇痛(PCA).针刺组麻醉诱导前及术中持续针刺手术患者双内关,术毕拔出针灸针,针刺穴位处贴上不透明的贴膜.对照组未行针灸,术毕在内关穴位置贴上相同贴膜.术后6 h、12 h、24 h、48 h随访,记录两组患者恶心、干呕和呕吐发生率及疼痛视觉模拟评分(VAS).结果:针刺组在术后6 h、12 h、24 h、48 h的恶心发生率分别为12.0%、6.0%:6.0%、2.0%,干呕的发生率分别为0、0、2.0%、2.0%;对照组恶心的发生率分别为28.0%、20.0%、12.0%、2.0%,干呕的发生率分别为2.0%、6.0%、2.0%、0,术后6 h、12 h恶心发生率,术后6 h、12 h、48 h干呕发生率,针刺组均低于对照组(P<0.05,P<0.001);两组患者均未发生呕吐;两组间术后VAS评分差异无统计学意义.结论:针刺内关可减少腹腔镜胃肠手术患者术后恶心、干呕的发生率,尤其在术后24 h内.

Prophylactic effect of acupuncture on nausea and vomiting after laparoscopic operation

Objective To explore the prophylactic effect of acupuncture Neiguan(PC 6)on nausea and vomiting after laparoscopic operation. Methods One hundred patients with laparoscopic gastrointestinal operation were randomly divided into an acupuncture group and a control group,50 patients in each group.The operation was carried out with the combined infusion and inhalation anesthesia.The patients in the acupuncture group were being punctured at bilateral Neiguan(PC 6)before anesthesia and during the operation.The needles were extracted after operation,and the acupoints were covered with opaque tape.In contrast,the patients in the control group only accepted tape covering without acupuncture.After operation,all patients were given the self-controlled intravenous analgesia,and followed up at 6 h,12 h,24 h,48 h for recording the incidence rate of the nausea,retching and vomiting,then scoring with VAS. Results At 6 h,12 h,24 h,48 h after operation,in the acupuncture group,the incidence rates of the nausea were 12.0%.,6.0%,6.0%and 2.0%,and the incidence rates of the retching were 0,0,2.0%and 2.0%,respectively;in the control group,the incidence rates of the nausea were 28.0%,20.0%,12.0%and 2.0%,and the incidence rates of the retching were 2.0%,6.0%,2.0%and 0,respectively.At 6 h,12 h after operation,the incidence rates of the nausea and retching in the acupuncture group were lower than those of the control group(P<0.05,P<0.001).The vomiting was not happened in both groups.There was no difference between the two groups according to the scoring with VAS. Conclusion Acupuncturing at Neiguan(PC 6)can reduce the incidence rates of the patients' nausea and retching after laparoscopic operation,especially in 24 h.