| 林宣晨.耳穴压豆辅助全麻对妇科腹腔镜术后血浆胃肠激素及恶心呕吐的影响[J].浙江中西医结合杂志,2017,27(3): |
| 耳穴压豆辅助全麻对妇科腹腔镜术后血浆胃肠激素及恶心呕吐的影响 |
| Effects of auricular point sticking assisted anesthesia on Plasma Gastrointestinal Hormones Level and Postoperative Nausea and Vomiting in Patients Undergoing Gynecological Laparoscopic Operation. |
| 投稿时间：2016-08-21 修订日期：2016-10-19 |
| DOI： |
| 中文关键词: 耳穴压豆 术后恶心呕吐 胃动素 腹腔镜手术 |
| 英文关键词:Auricular point sticking Postoperative nausea and vomiting Gastrointestinal Hormones Laparoscopy |
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| 中文摘要: |
| 【摘要】目的 观察耳穴压豆辅助全麻对妇科腹腔镜手术患者血浆胃泌素（GSA）、P物质（Substance P,SP）、胃动素（MTL）及术后恶心呕吐（PONV）的影响，为耳穴压豆的围术期应用提供理论依据。方法 将40例择期全麻下行妇科腹腔镜手术患者随机分为耳穴压豆组、安慰组，每组20例。耳穴压豆组取双耳穴神门、胃、贲门、交感，皮质下，于麻醉开始前30分钟、术毕清醒、术后2、6、24h给以耳豆每个穴位压一分钟，安慰组在相应穴位上黏贴外观相同的胶布。分别记录手术时间、麻醉时间、气腹压力、七氟烷用量、舒芬太尼用量、肛门恢复排气、排便时间；检测麻醉前30min（T0）、术后24h（T1）、术后48h（T2）血浆胃肠激素水平及听取肠鸣音；随访PONV的发生情况。结果 与安慰组比较，耳穴压豆组在T1和T2同时间点GSA、SP、MTL水平均显著降低（P<0.05），24h和48h内PONV发生率显著降低（P<0.05），肠鸣音恢复时间快（P<0.05），同时肛门恢复排气、排便时间明显缩短（P<0.05）。结论 耳穴压豆辅助全麻应用于妇科腹腔镜手术可减少血浆胃肠激素的释放，降低PONV发生率，加速胃肠功能恢复。 |
| 英文摘要: |
| Abstract Objective To observe the effects of auricular point sticking assisted anesthesia on plasma gastrointestinal hormones level and postoperative nausea and vomiting in patients undergoing gynecological laparoscopic operation, and provide evidence for peri-operative application of auricular point sticking. Methods Forty patients of selective gynecological laparoscopy under general anesthesia were randomly divided into auricular point sticking group and placebo group, with each group 20 patients. For auricular point sticking group, the auricular point sticking with vaccaria seeds was applied at Shenmen、Wei、Benmen、Jiaogan and Pizhixia bilaterally 30 min before anesthesia、Anesthesia awake and 2、6、24 h after operation, which were pressed 1 min each point each time. For the placebo group, sticking the same paste as auricular point sticking group at the corresponding points. Duration of operation and anesthesia, pneumoperitoneum pressure, consumption of sevoflurane and sufentanil, time of exhaustion were recorded, and the level of plasm gastrointestinal hormones was tested at three time points: prior to operation(T0), 24h after operation(T1) and 48h after operation(T2), and the occurrence of nausea and vomiting within 24h and 48h were also recorded. Results The level of plasma GSA、SP、MTL at T1 and T2 in auricular point sticking group were significantly lower than that in placebo group (P<0.05). The occurrence of nausea and vomiting within 24h and 48h were significantly lower than that in placebo group (P<0.05). The restitution time of borborygmi and exhaustion were significantly shorter than that in placebo group (P<0.05). Conclusion Auricular point sticking assisted anesthesia can reduce the release of gastrointestinal hormones, significantly lower the occurrence of nausea and vomiting and accelerate restitution of gastrointestinal function in patients undergoing gynecological laparoscopic operation. |
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