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| 揿针联合托烷司琼对腹腔镜全子宫切除术后恶心呕吐及炎性因子的影响 |
| Effects of press-needle combined with tropisetron on nausea and vomiting and inflammatory factors after laparoscopic hysterectomy |
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| DOI：10.12089/jca.2023.06.005 |
| 中文关键词: 揿针 托烷司琼 炎性因子 术后恶心呕吐 |
| 英文关键词: Press-needle Tropisetron Inflammatory factor Postoperative nausea and vomiting |
| 基金项目:河北省卫健委计划项目（20200391） |
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| 中文摘要: |
目的 观察揿针联合托烷司琼对腹腔镜全子宫切除术后恶心呕吐（PONV）及炎性因子的影响。
方法 选择择期全麻下行腹腔镜全子宫切除手术患者90例，年龄25～60岁，BMI 18～28 kg/m2，ASA Ⅰ或Ⅱ级。采用随机数字表法将患者随机分为三组：托烷司琼组（A组）、揿针组（B组）和揿针组联合托烷司琼（C组），每组30例。A组麻醉前30 min静脉推注托烷司琼5 mg；B组麻醉前30 min应用揿针刺激患者中脘、双侧内关、足三里穴，留针48 h；C组麻醉前30 min静脉推注托烷司琼5 mg，并应用揿针刺激患者中脘、双侧内关、足三里穴，留针48 h。记录术后6、12、24 h恶心呕吐严重程度评分、术后首次肛门排气和排便时间。分别在术前30 min和术后24 h抽取静脉血检测TNF-α和IL-6的浓度。
结果 与C组比较，术后6、12、24 h A组和B组恶心呕吐严重程度评分明显升高，术后24 h TNF-α和IL-6浓度明显升高（P＜0.05）。与A组比较，B组和C组术后首次肛门排气、排便时间明显缩短（P＜0.05）。
结论 揿针联合托烷司琼能够有效预防PONV的发生，改善胃肠功能，缓解免疫抑制，减轻术后炎症反应。 |
| 英文摘要: |
Objective To observe the effect of press-needle combined with tropisetron on nausea and vomiting (PONV) and inflammatory factors after laparoscopic hysterectomy.
Methods Ninty patients underwent elective laparoscopic hysterectomy under general anesthesia, aged 25-60 years, BMI 18-28 kg/m2, ASA physical status Ⅰ or Ⅱ. Patients were randomly divided into three groups: tropisetron group (group A), press-needle group (group B) and press-needle combined with tropisetron group (group C), 30 cases in each group. 5 mg tropisetron was injected intravenously 30 minutes before anesthesia in group A, Zhongwan point, bilateral Neiguan point and Zusanli point were stimulated by press-needle 30 minutes before anesthesia in group B, needle retention for 48 hours. Group C was injected intravenously with 5 mg tropisetron, and Zhongwan point, bilateral Neiguan point and Zusanli point were stimulated by press-needle 30 minutes before anesthesia, needle retention for 48 hours. The degree of postoperative nausea and vomiting at 6, 12 and 24 hours after operation, the first time of anal exhaust and defecation were recorded. Venous blood samples were taken 30 minutes before operation and 24 hours after operation to detect the concentration of TNF-α and IL-6.
Results Compared with group C, the degree of postoperative nausea and vomiting at 6, 12 and 24 hours after operation was significantly higher and the concentration of TNF-α and IL-6 was significantly increased in groups A and B (P < 0.05). Compared with group A, the first time of anal exhaust and defecation was significantly shorter in groups B and C (P < 0.05).
Conclusion Press-needle combined with tropisetron can effectively prevent PONV, improve gastrointestinal function, relieve immunosuppression and reduce postoperative inflammatory reaction. |
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