不同穴位针刺复合麻醉在功能性鼻内窥镜手术患者中的应用效果
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摘要
目的:探讨不同穴位针刺复合麻醉联合局部麻醉在功能性鼻内窥镜手术患者中的应用效果及对术后镇痛的影响。方法:将功能性鼻内窥镜手术患者80例随机分为2组均进行局部麻醉,对照组在此基础上针刺四白穴、下关穴、合谷穴和支沟穴,研究组在对照组治疗的基础上针刺迎香穴以及印堂穴,对比2组患者的麻醉效果及术后镇痛效果。结果:研究组患者有效率为95.0%,高于对照组的72.5%(P<0.05),麻醉效果优于对照组(P<0.05);各时间点VAS(视觉模拟法)评分均低于对照组(P<0.05)。结论:应用针刺迎香穴以及印堂穴复合麻醉联合局部麻醉有利于改善麻醉质量,提高患者的治疗效果及麻醉效果,降低患者术后疼痛。
Objective: To discuss the application effects of combined anesthesia by different acupoints needling to the patients undergoing functional nasal endoscope and its influence on postoperative analgesia.Methods: Eighty patients were assigned to both groups and accepted local anesthesia, the control group received the acupuncture at Sibai(ST2), Xiaguan(ST7), Hegu(LI4) and Zhigou(SJ6), and the experiment group at Yinxiang(LI20)and Yintang(EX-HN3), to compare anesthetic effects and postoperative analgesia effects between both groups.Results: The effective rate of the experiment group was 95.0% higher than 72.5% of the control group(P<0.05),superior to the control group in anesthetic effects(P<0.05); lower than the control group in VAS scores at different time points(P<0.05). Conclusion: Combined anesthesia by needling at Yinxiang and Yintang is helpful to improve anesthesia quality, enhance therapeutic effects and anesthesia effects and mitigate postoperative pain of the patients.
Objective: To discuss the application effects of combined anesthesia by different acupoints needling to the patients undergoing functional nasal endoscope and its influence on postoperative analgesia.Methods: Eighty patients were assigned to both groups and accepted local anesthesia, the control group received the acupuncture at Sibai(ST2), Xiaguan(ST7), Hegu(LI4) and Zhigou(SJ6), and the experiment group at Yinxiang(LI20)and Yintang(EX-HN3), to compare anesthetic effects and postoperative analgesia effects between both groups.Results: The effective rate of the experiment group was 95.0% higher than 72.5% of the control group(P<0.05),superior to the control group in anesthetic effects(P<0.05); lower than the control group in VAS scores at different time points(P<0.05). Conclusion: Combined anesthesia by needling at Yinxiang and Yintang is helpful to improve anesthesia quality, enhance therapeutic effects and anesthesia effects and mitigate postoperative pain of the patients.
引文
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[2]娄鸿飞.鼻及鼻窦炎的诊断标准介绍[J].中国医学文摘:耳鼻咽喉科学,2009(6):326-329.
[3]American Society for Gastrointestinal Endoscopy PIVI Committee,Chandrasekhara V,Desilets D,et al.The american society for gastrointestinal endoscopy PIVI(Preservation and Incorporation of Valuable Endoscopic Innovations)on peroral endoscopic myotomy[J].Gastrointest Endosc,2015,81(5):1087-1100.
[4]王明婕,林枫,张晓晴,等.功能性鼻内镜手术与轮廓化鼻内镜手术治疗难治性鼻窦炎的疗效分析[J].临床耳鼻咽喉头颈外科杂志,2017,31(3):185-190.
[5]许波,李筱,汪小海,等.应用右美托咪定联合芬太尼滴鼻功能性鼻内镜鼻窦手术术后的临床效果[J].重庆医学,2016,45(36):5163-5165.
[6]肖玲,陈璐,柯霞,等.术前VAS症状评分对慢性鼻-鼻窦炎围手术期的指导作用初步研究[J].临床耳鼻咽喉头颈外科杂志,2016,30(11):892-896.
[7]Pennazio M,Spada C,Eliakim R,et al.Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders:european society of gastrointestinal endoscopy(ESGE)clinical guideline[J].Endoscopy,2015,47(4):352-376.
[8]Dumonceau JM,Riphaus A,Schreiber F,et al.Non-anesthesiologist administration of propofol for gastrointestinal endoscopy:european society of gastrointestinal endoscopy,european society of gastroenterology and endoscopy nurses and associates guidelineupdated june 2015[J].Endoscopy,2015,47(12):1175-1189.
[9]余良才,马政旺,潘阳春,等.功能性内窥镜鼻窦术联合中鼻甲切除术治疗难治性鼻-鼻窦炎临床效果分析[J].海南医学,2016,27(2):294-296.
[10]王中霞.鼻渊丸对慢性鼻-鼻窦炎术后鼻黏膜恢复的影响[J].西部中医药,2016,29(5):90-92.
[11]Nishizawa T,Suzuki H,Kinoshita S,et al.Second-look endoscopy after endoscopic submucosal dissection for gastric neoplasms[J].Dig Endosc,2015,27(3):279-284.
[12]王敏.复发性鼻窦炎鼻息肉修正性手术及综合治疗效果分析[J].现代仪器与医疗,2016,22(4):47-49.
[13]Groenen MJ,Kuipers EJ,Van Berge Henegouwen GP,et al.Computerisation of endoscopy reports using standard reports and text blocks[J].Neth J Med,2016,64(3):78-83.
[14]郑伟昌,蒋慈英,张巧真.鼻窦内窥镜手术治疗慢性鼻-鼻窦炎的临床分析[J].皖南医学院学报,2016,35(1):63-66.
[15]刘健民,张云高.功能性内窥镜鼻窦手术的围手术期处理经验[J].临床军医杂志,2015,43(8):869-870.