文章摘要
穴位按压腕带联合托烷司琼对乳腺癌根治术患者术后早期恢复质量的影响
Effect of the acupressure wristbands combined with tropisetron on quality of recovery during early period after radical mastectomy
  
DOI：10.12089/jca.2018.04.008
中文关键词: 术后恶心呕吐  改良根治术  穴位按压腕带
英文关键词: Postoperative nausea and vomiting  Modified radical  Cupressure wristband
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作者单位E-mail
冯芳 230036,合肥市,中国科技大学附属省立医院南区麻醉科  
韩明明 230036,合肥市,中国科技大学附属省立医院南区麻醉科  
朱冰青 230036,合肥市,中国科技大学附属省立医院南区麻醉科  
康芳 230036,合肥市,中国科技大学附属省立医院南区麻醉科  
李娟 230036,合肥市,中国科技大学附属省立医院南区麻醉科 huamuzi1999@126.com 
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中文摘要:
      目的 评价穴位按压腕带联合托烷司琼对乳腺癌根治术患者术后恶心呕吐（PONV）以及早期恢复质量的影响。方法 择期全麻下行乳腺癌根治术患者75例,年龄35～68岁,ASA Ⅰ 或 Ⅱ 级。采用随机数字表法将患者分为三组:穴位按压腕带组(A组,25例)、托烷司琼组(B组,25例)、穴位按压腕带联合托烷司琼组(C组,25例)。A组:麻醉诱导前30 min,患者双侧前臂内关穴放置穴位按压腕带直至术后24 h。B组:手术结束前30 min静脉注射托烷司琼6 mg。C组:麻醉诱导前30 min,患者双侧前臂内关穴放置穴位按压腕带直至术后24 h;手术结束前30 min静脉注射托烷司琼6 mg。三组均接受全凭静脉麻醉。观察并记录拔管即刻、拔管即刻～术后6 h、术后6～24 h时间段恶心呕吐发生情况及严重程度。分别于术前1 d、术后1 d采用QoR-40量表对患者进行分项评估。结果 与A、B组比较, C组拔管即刻～术后6 h PONV发生率明显降低(P＜0.05),且术后24 h恶心呕吐分级明显降低(P＜0.05)。术后1 d C组身体舒适度评分、情绪状态评分和疼痛评分明显高于A、B组（P＜0.05或P＜0.01），QoR-40总评分明显高于A、B组（P＜0.01）。结论 穴位按压腕带联合托烷司琼能降低术后恶心呕吐发生率及严重程度,提高乳腺癌根治术患者术后早期恢复质量。
英文摘要:
      Objective To evaluate the effect of the acupressure wristbands combined with tropisetron on the effect in preventing postoperative nausea and vomiting (PONV) and the quality of recovery during early period after radical mastectomy. Methods Seventy-five patients, aged 35-68 years, ASA physical status Ⅰ or Ⅱ, scheduled for elective radical mastectomy, were randomly assigned into three groups (n=25): acupressure wristband group (group A), tropisetron group (group B) and acupressure wristbands combined with tropisetron group (group C). At 30 min before the surgery, the acupuncture pins were placed on Nei Guan point till 24 h after the surgery in group A. At 30 min before the end of the surgery, tropisetron 6 mg was intravenously injected in group B. At 30 min before the surgery, the acupuncture pins were placed on Nei Guan point till 24 h after the surgery; at 30 min before the end of the surgery, tropisetron 6 mg was intravenousy injected in group C. The three groups received total intravenous anesthesia. The occurrence of nausea and vomiting was recorded immediately after extubation, 6 h after surgery and 6-24 h after surgery. The global QoR-40 aggregate scores were recorded between the three groups on the day before surgery and 1 day after surgery. Results Compared with groups A and B, the incidence of PONV was significantly decreased in group C between the time immediately after extubation-6 h after surgery (P＜0.05); and the severity of PONV was significantly decreased in group C (P＜0.05). Compared with groups A and B, patients in group C produced higher physical comfort scores, emotional state scores, and pain scores (P＜0.05 or P＜0.01); the global QoR-40 scores of group C were significantly increased on 1 day after surgery (P＜0.01). Conclusion The acupressure wristbands combined with tropisetron can reduce the incidence and the severity of PONV, improve the quality of recovery during the early period after radical mastectomy.
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