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| 围术期颊针疗法对高龄患者髋关节置换术后谵妄的影响 |
| Effect of buccal acupuncture therapy during the perioperative period on postoperative delirium in elderly patients undergoing hip replacement surgery |
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| DOI：10.12089/jca.2025.03.007 |
| 中文关键词: 颊针 老年 髋关节置换术 术后谵妄 疼痛管理 |
| 英文关键词: Buccal acupuncture Aged Hip replacement surgery Postoperative delirium Pain management |
| 基金项目: |
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| 中文摘要: |
目的： 探究围术期颊针疗法对高龄患者髋关节置换术后谵妄(POD)的影响。
方法：选择2024年1—10月择期全麻下行髋关节置换术的患者80例，男36例，女44例，年龄75～90岁，BMI 18.5～24.0 kg/m2 ，ASA Ⅱ或Ⅲ级，采用随机数字表法将患者分为两组：颊针组和对照组，每组40例。对照组在全麻诱导前采用超声引导下髂筋膜间隙神经阻滞，颊针组于髂筋膜间隙神经阻滞麻醉前参照《颊针疗法》选穴进行颊针处理。记录术前1 d、术后1、2、3 d的静息时VAS疼痛评分，术后7 d POD、恶心呕吐、头晕头痛发生情况，术前1 d、术后1 d白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、神经烯醇化酶（NSE）、S-100β蛋白浓度。
结果：与对照组比较，颊针组术后1、2、3 d的静息时VAS疼痛评分明显降低（P<0.05），术后7 d内POD、恶心呕吐和头晕头痛发生率明显降低（P<0.05），术后1 d IL-6、TNF-α、NSE、S-100β蛋白浓度明显降低（P<0.05）。
结论： 围术期颊针疗法可明显降低高龄患者髋关节置换POD的发生率，降低术后疼痛及炎症水平。 |
| 英文摘要: |
Objective: To investigate the effect of perioperative buccal acupuncture pretreatment on postoperative delirium in elderly patients undergoing hip replacement surgery.
Methods: A total of 80 patients, 36 males and 44 females, aged 75-90 years, BMI 18.5-24.0 kg/m2 , ASA physical status Ⅱ or Ⅲ, who underwent elective hip replacement surgery under general anesthesia from January to October 2024 were selected. Patients were randomly divided into two groups using random number table method: the buccal acupuncture group and the control group, 40 patients in each group. The control group received ultrasound-guided fascia iliaca compartment block (FICB) anesthesia before general anesthesia induction, while the buccal acupuncture group received buccal acupuncture treatment at selected acupuncture points according to the “Buccal Acupuncture Therapy” protocol before FICB anesthesia. The length of hospital stay, resting visual analog scale (VAS) pain scores 1 day before surgery and 1, 2, and 3 days after surgery, incidence of postoperative delirium (POD), nausea and vomiting, headache, and dizziness within 7 days after surgery, levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), neuron-specific enolase (NSE), and S-100β protein 1 day after surgery were recorded.
Results: Compared with the control group, in the buccal acupuncture group, the resting VAS scores 1, 2, and 3 days after surgery were significantly lower (P < 0.05), the incidence of POD, nausea and vomiting, headache, and dizziness within 7 days after surgery were significantly lower (P < 0.05), the levels of IL-6, TNF-α, NSE, and S-100β protein 1 day after surgery were significantly decreased (P < 0.05).
Conclusion: Perioperative buccal acupuncture therapy can significantly reduce the incidence of POD, postoperative pain, and inflammatory levels in elderly patients undergoing hip replacement surgery. |
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