耳针疗法对剖宫产初产妇产后康复的影响
|
摘要
目的:探讨耳针疗法对剖宫产初产妇术后的影响,以期促进产后康复。方法:选取剖宫产分娩的初产妇120例随机分为观察组和对照组,各60例。两组均予术后常规治疗和护理。在此基础上,观察组取耳穴盆腔、神门、交感、皮质下、内生殖器、脾及胃进行毫针直刺,平补平泻,留针30 min,每日3次,两耳隔日交替针刺,连续治疗5 d。记录并比较两组初产妇产后疼痛情况、肛门排气时间,产后出血、尿潴留及便秘发生率和产后平均住院日。结果:观察组产后宫缩痛27例(45.0%)、创口痛25例(41.7%)、乳房胀痛19例(31.7%)及肌肉酸痛11例(18.3%),明显低于对照组的38例(63.3%)、36例(60.0%)、30例(50.0%)及21例(35.0%),差异有统计学意义(均P<0.05)。观察组产后肛门排气时间早于对照组(P<0.05),平均住院日短于对照组(P<0.05)。观察组产后出血、尿潴留及便秘的发生率均低于对照组(均P<0.05)。结论:耳针疗法可有效减轻剖宫产初产妇产后疼痛,同时促进产后排气和缩短住院日,并且降低产后出血、尿潴留及便秘等产后并发症的发生率,有利于产后康复。
Objective To explore the postoperative effect of auricular acupuncture on primipara with cesarean in order to promote postpartum rehabilitation. Methods A total of 120 primiparas with cesarean were randomly divided into an observation group and a control group, 60 cases in each group. The routine treatment and care after surgery were given in the two groups. On the basis treatment, auricular acupuncture was applied at penqiang(TF5), shenmen(TF4), jiaogan(AH6 a), pizhixia(AT4), neishengzhiqi(TF2), pi(CO13), wei(CO4) in the observation group, even-needling technique at all points.The needles were retained for 30 min, 3 times a day, the acupuncture was alternately every other day for 5 days continuously.The postpartum pain, anus exhaust time, incidence of postpartum hemorrhage, urinary retention and constipation, and postpartum average hospitalization day were recorded and compared between the two groups. Results Twenty-seven cases of postpartum uterine contraction pain(45.0%), 25 cases of wound pain(41.7%), 19 cases of breast distending pain(31.7%) and 11 cases of muscle soreness(18.3%) in the observation group, which was significantly lower than 38 cases(63.3%), 36 cases(60.0%), 30 cases(50.0%) and 21 cases(35.0%) respectively in the control group(P<0.05). The anus exhaust time in the observation group was earlier than that in the control group(P<0.05), and the average hospitalization time was shorter than that in the control group(P<0.05). The incidence of postpartum hemorrhage, urinary retention and constipation in the observation group was lower than that in the control group(P<0.05). Conclusion Auricular acupuncture can effectively relieve postpartum pain in primipara with cesarean, promote postpartum exhaust and shorten hospitalization days, and reduce the incidence of postpartum complications such as postpartum hemorrhage, urinary retention and constipation, it is conducive to postpartum rehabilitation.
Objective To explore the postoperative effect of auricular acupuncture on primipara with cesarean in order to promote postpartum rehabilitation. Methods A total of 120 primiparas with cesarean were randomly divided into an observation group and a control group, 60 cases in each group. The routine treatment and care after surgery were given in the two groups. On the basis treatment, auricular acupuncture was applied at penqiang(TF5), shenmen(TF4), jiaogan(AH6 a), pizhixia(AT4), neishengzhiqi(TF2), pi(CO13), wei(CO4) in the observation group, even-needling technique at all points.The needles were retained for 30 min, 3 times a day, the acupuncture was alternately every other day for 5 days continuously.The postpartum pain, anus exhaust time, incidence of postpartum hemorrhage, urinary retention and constipation, and postpartum average hospitalization day were recorded and compared between the two groups. Results Twenty-seven cases of postpartum uterine contraction pain(45.0%), 25 cases of wound pain(41.7%), 19 cases of breast distending pain(31.7%) and 11 cases of muscle soreness(18.3%) in the observation group, which was significantly lower than 38 cases(63.3%), 36 cases(60.0%), 30 cases(50.0%) and 21 cases(35.0%) respectively in the control group(P<0.05). The anus exhaust time in the observation group was earlier than that in the control group(P<0.05), and the average hospitalization time was shorter than that in the control group(P<0.05). The incidence of postpartum hemorrhage, urinary retention and constipation in the observation group was lower than that in the control group(P<0.05). Conclusion Auricular acupuncture can effectively relieve postpartum pain in primipara with cesarean, promote postpartum exhaust and shorten hospitalization days, and reduce the incidence of postpartum complications such as postpartum hemorrhage, urinary retention and constipation, it is conducive to postpartum rehabilitation.
引文
[1]张青花.急症剖宫产与择期剖宫产临床处理对比[J].社区医学杂志,2012,10(8):15-16.
[2]廖予妹,耿正惠.中国剖宫产现状及其远期影响[J].中国实用妇科与产科杂志,2010,26(8):630-632.
[3]Engelbrechtsen L,Nielsen EH,Perin T,et al.Cesarean section for the second twin:a population-based study of occurrence and outcome[J].Birth,2013,40(1):10-16.
[4]王曙光,陈晓园,周丽萍,等.剖宫产与阴道分娩对女性产后性功能影响的比较研究[J].中国性科学,2012,21(8):19-21.
[5]周静珠,王茵萍,仲远明.耳针疗法治疗消化系统疾病的临床研究[J].针灸临床杂志,2011,27(7):54-56.
[6]杨卉.耳针疗法作用机理的研究进展[J].湖北中医药大学学报,2011,13(2):65-66.
[7]谢幸,苟文丽.妇产科学[M].北京:人民军医出版社,2013:187-210.
[8]杨海兰.545例产妇产后疼痛的原因分析及临床护理干预对策[J].中国医学创新,2012,9(25):54-55.
[9]何冰君,曹睿.剖宫产妇疼痛及产后康复的影响因素分析及临床干预[J].西部医学,2016,28(10):1474-1477.
[10]吴杞.图解耳压疗法[M].北京:人民军医出版社,2007:4-44.
[11]张阳德,林伶,陈紫煜.耳穴按压对腹腔镜术后胃肠功能恢复的影响[J].中国内镜杂志,2011,11(10):1014-1018.
[12]王洪秀.促进剖宫产术后肛门排气方法的研究[J].黑龙江医药,2009,22(2):156-157.
[13]兰晓娥.耳穴按摩促进妇科腹腔镜术后患者肛门排气效果观察[J].护理学杂志,2008,23(4):50-51.
[14]刘悦,章小平,龙目恒,等.针刺耳穴贴压治疗功能性消化不良疗效观察[J].中国针灸,2002,22(6):366-368.
[15]应豪,段涛.剖宫产与产后出血[J].实用妇产科杂志,2011,27(3):165-167.
[16]中华医学会妇产科学分会产科学组.产后出血预防与处理指南(草案)[J].中华妇产科杂志,2009,44(7):554-557.
[17]陈红珍.产后尿潴留的发生原因及护理研究进展[J].护理研究,2016,30(540):1924-1927.
[18]娄建玲.针刺干预产后便秘护理体会[J].河北中医,2015,37(7):1100-1101.
[19]沙吾列古丽·卡马尔旦,帕古丽·海巴依.剖宫产后产妇便秘的护理[J].中国社区医师,2013,15(6):348.
[20]刘智艳,姚小红.耳针疗法作用机理研究进展[J].针灸临床杂志,2005,21(4):62-63.
[2]廖予妹,耿正惠.中国剖宫产现状及其远期影响[J].中国实用妇科与产科杂志,2010,26(8):630-632.
[3]Engelbrechtsen L,Nielsen EH,Perin T,et al.Cesarean section for the second twin:a population-based study of occurrence and outcome[J].Birth,2013,40(1):10-16.
[4]王曙光,陈晓园,周丽萍,等.剖宫产与阴道分娩对女性产后性功能影响的比较研究[J].中国性科学,2012,21(8):19-21.
[5]周静珠,王茵萍,仲远明.耳针疗法治疗消化系统疾病的临床研究[J].针灸临床杂志,2011,27(7):54-56.
[6]杨卉.耳针疗法作用机理的研究进展[J].湖北中医药大学学报,2011,13(2):65-66.
[7]谢幸,苟文丽.妇产科学[M].北京:人民军医出版社,2013:187-210.
[8]杨海兰.545例产妇产后疼痛的原因分析及临床护理干预对策[J].中国医学创新,2012,9(25):54-55.
[9]何冰君,曹睿.剖宫产妇疼痛及产后康复的影响因素分析及临床干预[J].西部医学,2016,28(10):1474-1477.
[10]吴杞.图解耳压疗法[M].北京:人民军医出版社,2007:4-44.
[11]张阳德,林伶,陈紫煜.耳穴按压对腹腔镜术后胃肠功能恢复的影响[J].中国内镜杂志,2011,11(10):1014-1018.
[12]王洪秀.促进剖宫产术后肛门排气方法的研究[J].黑龙江医药,2009,22(2):156-157.
[13]兰晓娥.耳穴按摩促进妇科腹腔镜术后患者肛门排气效果观察[J].护理学杂志,2008,23(4):50-51.
[14]刘悦,章小平,龙目恒,等.针刺耳穴贴压治疗功能性消化不良疗效观察[J].中国针灸,2002,22(6):366-368.
[15]应豪,段涛.剖宫产与产后出血[J].实用妇产科杂志,2011,27(3):165-167.
[16]中华医学会妇产科学分会产科学组.产后出血预防与处理指南(草案)[J].中华妇产科杂志,2009,44(7):554-557.
[17]陈红珍.产后尿潴留的发生原因及护理研究进展[J].护理研究,2016,30(540):1924-1927.
[18]娄建玲.针刺干预产后便秘护理体会[J].河北中医,2015,37(7):1100-1101.
[19]沙吾列古丽·卡马尔旦,帕古丽·海巴依.剖宫产后产妇便秘的护理[J].中国社区医师,2013,15(6):348.
[20]刘智艳,姚小红.耳针疗法作用机理研究进展[J].针灸临床杂志,2005,21(4):62-63.