摘要
目的:观察耳穴压豆对妇科腹腔镜手术后胃肠运动功能的影响。方法:选取妇科腔镜手术患者90例,随机分为治疗组、对照组和空白对照组各30例。治疗组神门、胃和贲门行王不留行籽贴压耳穴,记录术后恢复排气、排便时间并听取肠鸣音,检测麻醉前30 min、术后24 h、术后48 h血浆胃动素(MTL)、胃泌素(GAS)、血管活性肠肽(VIP)水平,以及术后恶心呕吐的情况。结果:治疗组术后恶心呕吐发生率与对照组相比降低(10%vs 30%;P<0.05),恢复排气时间明显缩短[(23.0±6.1)h vs(30.2±6.7)h,P<0.05],排便时间也缩短[(40.5±5.5)h vs(60.4±8.9)h,P<0.05];治疗组术后24 h、48 h血浆MLT水平较对照组明显降低[(349.45±25.75)pg/m L vs(378.89±23.97)pg/m L;(301.34±36.32)pg/m L vs(368.64±20.67)pg/m L,P<0.05];治疗组术后24 h、48 h血浆GAS水平明显升高[(149.45±25.75)pg/m L vs(136.43±27.09)pg/m L;(168.34±21.60)pg/m L vs(142.34±32.57)pg/m L,P<0.05];治疗组术后24 h、48 h血浆VIP水平也明显升高[(42.45±2.75)pg/m L vs(39.89±2.97)pg/m L;(30.34±3.32)pg/m L vs(37.64±2.67)pg/m L,P<0.05]。结论:耳穴压豆在一定程度上可以增强昂丹司琼的镇吐作用,减轻妇科腔镜手术后恶心呕吐,促进胃肠运动功能恢复,其机制可能是其抑制MLT释放、促进GAS和VIP的释放。
Objective To explore the influence of auricular point sticking on gastrointestinal motility after gynecological laparoscopic operation with general anesthesia.Methods Ninety patients undergoing gynecological laparoscopic operation with general anesthesia were included.The patients were randomly divided into the treatment group,control group and blank control group,30cases in each group.The patients in treatment group were treated with auricular sticking at Shenmen(TF4),Wei(CO4)and Benmen(CO3)using acupressure seeds named Semen Vaccariae.The anus exhaust time,defecating time and borborygmus were recorded,the levels of plasma MTL,GAS and VIP were tested at30min before anesthesia,24h and48h after operation.The occurrence of nausea and vomiting was also recorded.Results The occurrence of nausea and vomiting after operation was reduced in the treatment group(10%vs30%;P<0.05),and the anus exhaust time and anal defectation time were shortened[(23.0±6.1)h vs(30.2±6.7)h;(40.5±5.5)h vs(60.4±8.9)h,P<0.05],when compared to control group.The levels of MTL in the treatment group at24h and48h after operation were lower than those of blank control group and the control group.However,the levels of GAS at24h and48h after operation in treatment group were higher than those of control group[(149.45±25.75)pg/mL vs(136.43±27.09)pg/mL;(168.34±21.60)pg/mL vs(142.34±32.57)pg/mL,P<0.05]The levels of VIP in24h and48h after operation in treatment group were higher than those of control group[(42.45±2.75)pg/mL vs(39.89±2.97)pg/mL;(30.34±3.32)pg/mL vs(37.64±2.67)pg/mL,P<0.05].Conclusion The auricular acupressure could relive the occurrence of nausea and vomiting after gynecological laparoscopic operation with general anesthesia.The mechanism may be connected with the suppression of MLT and release of GAS and VIP.
作者
武丽娜
余剑波
宫丽荣
WU Li-na;YU Jian-bo;GONG Li-rong(Department of Anesthesiology,Tianjin Nankai Hospital ,Tianjin 300100 ,China)
出处
《中国中西医结合外科杂志》
CAS
2017年第6期626-629,共4页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
关键词
耳穴压豆
妇科手术
腹腔镜
胃肠运动功能
胃肠激素
Auricular point sticking
gyynecological operation
laparoscopy
gastrointestinal motility
gastrointestinal hormones
