|
| 围术期颊针疗法对日间胸腔镜交感神经切断术患者术后恢复的影响 |
| Effect of perioperative buccal acupuncture therapy on postoperative recovery in patients undergoing thoracoscopic sympathectomy during daytime |
| |
| DOI：10.12089/jca.2025.08.007 |
| 中文关键词: 围术期 颊针疗法 手汗症 日间手术 肺顺应性 术后疼痛 加速术后康复 |
| 英文关键词: Perioperative period Buccal acupuncture therapy Palmer hyperhidrosis Day surgery Lung compliance Postoperative pain Enhanced recovery after surgery |
| 基金项目:南京市卫生科技发展专项资金项目（2022YKK22257） |
|
| 摘要点击次数: 400 |
| 全文下载次数: 104 |
| 中文摘要: |
目的： 探讨围术期颊针疗法对日间胸腔镜交感神经切断术患者术后恢复的影响。
方法：选择择期全麻下行日间胸腔镜交感神经切断术的手汗症患者92例，男51例，女41例，年龄18～35岁，BMI 18.5～25.0 kg/m2，ASA Ⅰ或Ⅱ级。采用随机数字表法将患者分为两组：颊针疗法组（A组）和对照组（C组），每组46例。A组在麻醉诱导前5 min给予双侧颈穴、背穴、上焦穴颊针治疗，留针20 min后拔除颊针。对照组不予颊针治疗。两组患者均采用气管内插管全身麻醉。记录术前、双肺交替肺萎陷停呼吸前、膨肺后机械通气时、气管导管拔管前的HR、MAP、肺动态顺应性（Cdyn）、气道峰压（Ppeak）。记录气管导管拔除时间、PACU停留时间、术后病房留观时间、术后6 h内补救镇痛情况、术后6、12 h的VAS疼痛评分。记录术后肺部并发症发生情况。
结果：与术前比较，两组气管导管拔除前Cdyn明显降低（P<0.05）。与C组比较，A组双肺交替肺萎陷停呼吸前、膨肺后机械通气时、气管导管拔管前Cdyn明显升高，膨肺后机械通气时和气管导管拔管前的Ppeak明显降低（P<0.05）。与C组比较，A组气管导管拔除时间、PACU停留时间和术后病房留观时间明显缩短，术后6 h补救镇痛例数明显减少，术后6 h VAS疼痛评分明显下降，术中舒芬太尼用量明显减少（P<0.05）。两组术后肺部并发症发生率差异无统计学意义。
结论：围术期颊针疗法可以改善日间手汗症胸腔镜手术患者术中肺顺应性，降低气道压力，可更早期拔除气管导管，同时减轻术后疼痛，提高术后恢复质量，缩短术后留观时间。 |
| 英文摘要: |
Objective: To investigate the effect in perioperative buccal acupuncture therapy on postoperative recovery in patients undergoing thoracoscopic sympathectomy during daytime.
Methods: Ninety-two patients scheduled for elective thoracoscopic sympathectomy for palmar hyperhidrosis under general anesthesia were selected, including 51 males and 41 females, aged 18-35 years, BMI 18-25 kg/m2, ASA physical status Ⅰ or Ⅱ. Patients were randomly divided into two groups using a random number table: the buccal acupuncture therapy group (group A) and the control group (group C), 46 patients in each group. Group A was treated with cheek needles at bilateral neck points, back points and upper jiao points 5 minutes before anesthesia induction, and the cheek needles were removed after leaving the needles for 20 minutes. The control group was not treated with cheek needle. Both groups were given endotracheal intubation general anesthesia. HR, MAP, dynamic lung compliance (Cdyn), and airway peak pressure (Ppeak) were recorded before surgery, before alternate pulmonary collapse and stop breathing, during mechanical ventilation after lung expansion, and before tracheal catheter extraction. Tracheal catheter removal time, PACU residence time, postoperative observation time in the ward, within 6 hours postoperatively supplementary analgesia, 6 and 12 hours after surgery VAS pain scores were recorded. The postoperative pulmonary complications were recorded.
Results: Compared with preoperative results, Cdyn before tracheal catheter extubation was significantly decreased in both groups (P < 0.05). Compared with group C, Cdyn in group A was significantly increased before alternating pulmonary collapse, mechanical ventilation after lung expansion, and before tracheal catheter extubation, while Ppeak in group A was significantly decreased during mechanical ventilation after lung expansion and before tracheal catheter extubation (P < 0.05). Compared with group C, the tracheal catheter removal time, PACU residence time and postoperative observation time in the ward of group A were significantly shortened, the number of supplementary analgesia within 6 hours postoperatively was significantly reduced, the VAS pain score 6 hours after surgery was significantly decreased, and the intraoperative sufentanil dosage was decreased in group A (P < 0.05). There was no significant difference in the incidence of postoperative pulmonary complications between the two groups.
Conclusion: Perioperative buccal acupuncture can improve the pulmonary compliance in patients undergoing thoracoscopic surgery for daytime handhidrosis, reduce airway pressure, remove tracheal catheter earlier, and reduce postoperative pain, thus improving postoperative recovery quality and shortening hospital observation time. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
