电针复合阴部神经阻滞在肛瘘手术中应用的临床研究
Clinical study of electroacupuncture combined with pudendal nerve block in anal fistula operation
- 上海中医药大学学报 2022年36卷第S1期 页码：96-99
- 作者机构：
1.上海中医药大学附属曙光医院麻醉科（上海 201203）
- 作者简介：
宋伟，女，硕士，主治医师，主要从事疼痛信号的转导与调制机制、针药复合麻醉的临床研究
严君君，女，学士，护师，主要从事围术期加速康复的临床研究（本文贡献与第一作者等同
唐炜，副主任医师；E-mail：976711152@qq.com
- 基金信息：国家自然科学基金资助项目(81603700;81973652)
DOI：10.16306/j.1008-861x.2022.S1.024
中图分类号：
扫 描 看 全 文
宋伟,严君君,薛慧等.电针复合阴部神经阻滞在肛瘘手术中应用的临床研究[J].上海中医药大学学报,2022,36(S1):96-99.
SONG Wei,YAN Junjun,XUE Hui,et al.Clinical study of electroacupuncture combined with pudendal nerve block in anal fistula operation[J].Academic Journal of Shanghai University of Traditional Chinese Medicine,2022,36(S1):96-99.
宋伟,严君君,薛慧等.电针复合阴部神经阻滞在肛瘘手术中应用的临床研究[J].上海中医药大学学报,2022,36(S1):96-99. DOI： 10.16306/j.1008-861x.2022.S1.024.
SONG Wei,YAN Junjun,XUE Hui,et al.Clinical study of electroacupuncture combined with pudendal nerve block in anal fistula operation[J].Academic Journal of Shanghai University of Traditional Chinese Medicine,2022,36(S1):96-99. DOI： 10.16306/j.1008-861x.2022.S1.024.
摘要
目的,2,观察电针复合阴部神经阻滞在肛瘘手术中应用的临床疗效。,方法,2,纳入120例接受肛瘘手术患者作为研究对象，随机分为试验组（电针八髎穴复合阴部神经阻滞）与对照组（脊麻），每组60例。比较两组患者术前术中平均动脉压（MAP）和心率（HR）变化、手术操作时间、术后第一次疼痛的时间、术后各时段的疼痛分级以及术后并发症情况，同时进行安全性评价。,结果,2,①试验组术前术中平均动脉压和心率均没有显著性差异（,P,>,0.05），对照组术中平均动脉压和心率比术前均降低（,P,<,0.05）。②两组手术时间无明显差异（,P,>,0.05），试验组术后第一次疼痛的发生时间相比对照组明显延长（,P,<,0.05）。③术后6 h、12 h、24 h，试验组患者疼痛程度比对照组低。④试验组术后尿潴留及恶心呕吐发生率比对照组明显减少。,结论,2,电针八髎穴联合阴部神经阻滞的麻醉方式，可满足手术所需的镇痛和肛门松弛需求，不引起循环波动，并且术后可以维持更长的镇痛时间，保留更优的运动功能，促进患者快速康复（ERAS）。
Abstract
Objective： To observe the clinical efficacy of electroacupuncture combined with pudendal nerve block in anal fistula operation.,Methods,2,One hundred and twenty patients undergoing anal fistula operation were taken as subjects， and were randomly divided into the experimental group （electroacupuncture at Baliao acupoint combined with pudendal nerve block） and the control group （spinal anesthesia）， 60 cases in each group. The changes of mean arterial pressure （MAP） and heart rate （HR） before and after operation， the time of operation， the time of the first postoperative pain， the grade of postoperative pain and the postoperative complications were compared between the two groups， and the safety was evaluated at the same time.,Results,2,①There was no significant difference in preoperative and intraoperative mean arterial pressure and heart rate in the experimental group （,P,>,0.05）， and the intraoperative mean arterial pressure and heart rate in the control group were lower than those before operation （,P,<,0.05）. ②There was no significant difference in operation time between the two groups （,P,>,0.05）. The occurrence time of the first postoperative pain in the experimental group was significantly prolonged compared with that in the control group （,P,<,0.05）. ③At 6 h， 12 h and 24 h after operation， the degree of pain in the experimental group was lower than that in the control group. ④The incidence rates of postoperative urinary retention and nausea and vomiting in the experimental group were significantly lower than those in the control group.,Conclusion,2,The anesthetic method of electroacupuncture at Baliao acupoint combined with pudendal nerve block can meet the needs of analgesia and anal relaxation required by operation， with no circulatory fluctuation， but longer analgesia time and better motor function， which could promote the enhanced recovery after surgery （ERAS）.
关键词
电针八髎穴阴部神经阻滞肛瘘肛肠手术麻醉脊麻
Keywords
electroacupunctureBaliao acupointpudendal nerve blockanal fistulaanorectal surgeryanesthesiaspinal anesthesia
references
SIMPSON J A， BANERJEA A， SCHOLEFIELD J H. Management of anal fistula［J］. BMJ， 2012， 345： e6705.
AMATO A， BOTTINI C， DE NARDI P， et al. Evaluation and management of perianal abscess and anal fistula： a consensus statement developed by the Italian Society of Colorectal Surgery （SICCR）［J］. Tech Coloproctol， 2015， 19（10）： 595-606.
SIDDIQUI Z I， DENMAN W T， SCHUMANN R， et al. Local anesthetic infiltration versus caudal epidural block for anorectal surgery： a randomized controlled trial［J］. J Clin Anesth， 2007， 19（4） ： 269-273.
国家中医药管理局. 中医病证诊断疗效标准［M］. 南京：南京大学出版社，1994.
WANG K， XIANG X H， QIAO N， et al. Genomewide analysis of rat periaqueductal gray-dorsal horn reveals time-， region-and frequency-specific mRNA expression changes in response to electroacupuncture stimulation［J］. Sci Rep， 2014（4）： 6713.
NAJA Z， ZIADE M F， LÖNNQVIST P A. Nerve stimulator guided pudendal nerve block decreases posthemorrhoidectomy pain［J］. Can J Anaesth， 2005， 52（1）： 62-68.
GUDAITYTE J， MARCHERTIENE I， PAVALKIS D. Anesthesia for ambulatory anorectal surgery［J］. Medicina （Kaunas）， 2004， 40（2）： 101-111.
张杨，黄西，涂发平. 阴部神经阻滞临床应用研究进展［J］. 黑龙江科学，2021， 12（8）： 51-52，55.
MONGELLI F， TREGLIA G， LA Regina D， et al. Pudendal Nerve Block in Hemorrhoid Surgery： A Systematic Review and Meta-analysis［J］. Dis Colon Rectum， 2021， 64（5）： 617-631.
CHENG L L， DING M X， XIONG C， et al. Effects of electroacupuncture of different frequencies on the release profile of endogenous opioid peptides in the central nerve system of goats［J］. Evid Based Complement Alternat Med， 2012， 2012： 476457.
CHENG L L， DING M X， WEI J， et al. Electroacupuncture-induced dynamic processes of gene expression levels of endogenous opioid Peptide precursors and opioid receptors in the CNS of goats［J］. Evid Based Complement Alternat Med， 2013， 2013： 257682.
HAN J S. Acupuncture analgesia： areas of consensus and controversy［J］. Pain， 2011， 152（3 Suppl）： S41-S48.
WANG J Q， MAO L， HAN J S. Comparison of the antinociceptive effects induced by electroacupuncture and transcutaneous electrical nerve stimulation in the rat［J］. Int J Neurosci， 1992， 65（1-4）： 117-129.
PARRISH A B， O'NEILL S M， CRAIN S R， et al. An Enhanced Recovery After Surgery （ERAS） Protocol for Ambulatory Anorectal Surgery Reduced Postoperative Pain and Unplanned Returns to Care After Discharge［J］. World J Surg， 2018， 42（7）： 1929-1938.
0
浏览量
92
下载量
0
CSCD
0
CNKI被引量
- 网络PDF下载
- BibTeX下载
- Endnote下载
- RefMan 下载
- NoteExpress下载
- NoteFirst下载
关联资源
相关文章
相关作者
相关机构
- 技术支持由北京北大方正电子有限公司提供 京ICP备09064830号-19
京公网安备11010802024621 - 本系统建议在Chrome、 IE9+ 以上版本浏览器阅读本站内容，360浏览器请切换至极速模式
- Cookies帮助我们提供服务并提供个性化体验。使用本网站，即表示您同意我们使用Cookies
- 总访问量：10154 今日访问量：17