电针预处理联合诱导排尿对混合痔外剥内扎术后尿潴留的影响
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摘要
目的:评价电针预处理联合诱导排尿对混合痔外剥内扎术后尿潴留的影响。方法:将80例行外剥内扎术的混合痔患者随机分为电针组和常规组,每组40例。两组均行腰俞穴麻醉。电针组予术前30 min电针中极、关元、膀胱俞、三阴交穴,采用2 Hz/100 Hz疏密波,刺激强度以患者可耐受为度;术后予诱导排尿,即热敷膀胱区及听流水声。常规组仅术后予诱导排尿。比较两组术后首次排尿尿等待时间评分、术后当晚小腹胀满感评分、首次排尿量及尿潴留发生率。结果:电针组术后首次排尿尿等待时间评分及术后当晚小腹胀满感评分低于常规组,首次排尿量多于常规组,尿潴留发生率低于常规组[5.0%(2/40)vs 22.5%(9/40)],差异均有统计学意义(均P<0.05)。结论:电针预处理联合诱导排尿可以有效预防混合痔外剥内扎术后尿潴留的发生。
Objective To investigate the effect of electroacupuncture preconditioning combined with induced urination on urinary retention after milligan-morgan hemorrhoidectomy. Methods Eighty patients with mixed hemorrhoids were randomly divided into an electroacupuncture group and a routine group, 40 cases in each group. Anesthesia at Yaoshu(GV 2) was given in the two groups. In the electroacupuncture group, electroacupuncture at Zhongji(CV 3),Guanyuan(CV 4),Pangguangshu(BL 28) and Sanyinjiao(SP 6) was applied with tolerant intensity for 30 min before operation, 2 Hz/100 Hz in frequency. After operation, induced urination was given, namely hot compress of bladder area and sound of hearing water. In the routine group,induced urination was given after operation. The score of the first urination waiting time, the distension of lower abdomen on the evening of the postoperative, the first time urinary volume and incidence of urinary retention were compared between the two groups. Results The scores of the first urination waiting time after operation and distension of lower abdomen in the evening of the postoperative in the electroacupuncture group were lower than those in the routine group,the first time urinary volume was more than that in the routine group, and the incidence of urinary retention was lower than that in the routine group(5.0%(2/40) vs 22.5%(9/40), all P<0.05). Conclusion Electroacupuncture preconditioning combined with induced urination can effectively prevent the incidence of urinary retention after milligan-morgan hemorrhoidectomy.
Objective To investigate the effect of electroacupuncture preconditioning combined with induced urination on urinary retention after milligan-morgan hemorrhoidectomy. Methods Eighty patients with mixed hemorrhoids were randomly divided into an electroacupuncture group and a routine group, 40 cases in each group. Anesthesia at Yaoshu(GV 2) was given in the two groups. In the electroacupuncture group, electroacupuncture at Zhongji(CV 3),Guanyuan(CV 4),Pangguangshu(BL 28) and Sanyinjiao(SP 6) was applied with tolerant intensity for 30 min before operation, 2 Hz/100 Hz in frequency. After operation, induced urination was given, namely hot compress of bladder area and sound of hearing water. In the routine group,induced urination was given after operation. The score of the first urination waiting time, the distension of lower abdomen on the evening of the postoperative, the first time urinary volume and incidence of urinary retention were compared between the two groups. Results The scores of the first urination waiting time after operation and distension of lower abdomen in the evening of the postoperative in the electroacupuncture group were lower than those in the routine group,the first time urinary volume was more than that in the routine group, and the incidence of urinary retention was lower than that in the routine group(5.0%(2/40) vs 22.5%(9/40), all P<0.05). Conclusion Electroacupuncture preconditioning combined with induced urination can effectively prevent the incidence of urinary retention after milligan-morgan hemorrhoidectomy.
引文
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[12]陈爱霞,王欣,吴春晓,等.八正散加减对痔瘘术后湿热下注型尿潴留患者排尿时间及自行排尿能力恢复的影响[J].中国实验方剂学杂志,2017,23(20):169-173.
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[19]李晶,胡金华.雷火灸治疗痔术后尿潴留60例[J].中国针灸,2014,34(3):284.
[20]杜文武,李思蓉,张亚峰,等.不同时间段按摩配合穴位注射预防混合痔术后尿潴留的临床观察[J].成都中医药大学学报,2016,39(4):59-62.
[21]王斌,白世斌,秦凯龙.针灸联合膀胱区穴位按摩治疗肛肠术后尿潴留的临床观察[J].中国中医急症,2017,26(4):708-710.
[22]王朝辉,许娜,龙天雷,等.针刺治疗手术后尿潴留临床疗效的Meta分析[J].时珍国医国药,2015,26(11):2815-2818.
[2]陈林,陈朝晖,张瑞芳,等.灸法治疗肛肠术后尿潴留临床研究[J].中国针灸,2013,33(1):17-19.
[3]胡慧,谢占国,覃蔚岚,等.不同介入时期电针对宫颈癌术后膀胱功能恢复的影响[J].针刺研究,2013,38(1):64-67,77.
[4]程莉莉,吴聪英,睢明河.电针不同穴位对急性尿潴留后家兔膀胱内压和膀胱组织三磷酸腺苷含量的影响[J].针刺研究,2012,37(4):291-295.
[5]龙庆,李艳,李俊,等.电针联合耳穴贴压治疗混合痔外剥内扎术后肛门疼痛临床研究[J].中国针灸,2018,38(6):580-584.
[6]中华中医药学会.中医肛肠科常见病诊疗指南[M].北京:中国中医药出版社,2012:1-4.
[7]张东铭.痔病[M].北京:人民卫生出版社,2005:255.
[8]黄楚真,颜小香,达叶春.混合痔患者术后尿潴留原因分析及中医护理[J].吉林医学,2015,36(9):1859-1860.
[9]付欢欢,余苏萍.肛肠术后尿潴留的中西医治疗进展[J].现代中西医结合杂志,2016,25(17):1927-1930.
[10]冯月宁,冯大勇,王春晖,等.中医多途径综合疗法治疗肛肠术后尿潴留临床研究[J].辽宁中医药大学学报,2015,17(5):205-207.
[11]吴美治.早期膀胱区热敷对PPH术后尿潴留护理效果的影响[J].中国卫生标准管理,2015,6(21):217-218.
[12]陈爱霞,王欣,吴春晓,等.八正散加减对痔瘘术后湿热下注型尿潴留患者排尿时间及自行排尿能力恢复的影响[J].中国实验方剂学杂志,2017,23(20):169-173.
[13]Afazel MR,Jalali E,Sadat Z,et al.Comparing the effects of hot pack and lukewarm-water-soaked gauze on postoperative urinary retention:a randomized controlled clinical trial[J].Nurs Midwifery Stud,2014,3(4):e24606.
[14]聂玉红.两种不同诱导排尿方式在术后尿潴留患者中的效果观察[J].泰山医学院学报,2009,30(9):719-720.
[15]张永旺,李虹,曾绩娟,等.白玉兰主任医师治疗盆、腹腔术后尿潴留的临床经验[J].现代中医临床,2014,21(5):31-33.
[16]高寅秋,时金华,李辛洁,等.电针治疗腰麻后尿潴留的疗效观察[J].世界中医药,2017,12(10):2280-2283,2287.
[17]杨振杰,肖学伟.电针阴陵泉、三阴交穴对宫颈癌根治术后尿潴留疗效对比研究[J].亚太传统医药,2016,12(22):83-84.
[18]萧华文,沈卫东.电针八髎穴治疗肛肠术后疼痛和术后恢复的疗效观察[J].四川中医,2015,33(3):159-161.
[19]李晶,胡金华.雷火灸治疗痔术后尿潴留60例[J].中国针灸,2014,34(3):284.
[20]杜文武,李思蓉,张亚峰,等.不同时间段按摩配合穴位注射预防混合痔术后尿潴留的临床观察[J].成都中医药大学学报,2016,39(4):59-62.
[21]王斌,白世斌,秦凯龙.针灸联合膀胱区穴位按摩治疗肛肠术后尿潴留的临床观察[J].中国中医急症,2017,26(4):708-710.
[22]王朝辉,许娜,龙天雷,等.针刺治疗手术后尿潴留临床疗效的Meta分析[J].时珍国医国药,2015,26(11):2815-2818.