作　　者： (）;

机构地区： 广州中医药大学第二附属医院

出　　处： 《中国针灸》 2020年第2期147-151,共5页

摘　　要： 目的:观察腕踝针对椎间孔镜手术患者术中辅助镇痛的作用。方法:将64例行经皮侧路椎间孔镜手术的腰椎间盘突出症患者随机分成观察组和对照组,每组32例。对照组采用1%利多卡因注射液常规局部浸润麻醉;观察组实施常规局部浸润麻醉前5 min于下5、下6行腕踝针治疗,在进针后即刻、15 min、30 min分别施以左右摆动、上抬下压、左右旋转手法各6次,留针30 min。比较两组患者术中穿刺(T1)、环锯打磨时(T2)、置放工作通道完成时(T3)平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)及疼痛视觉模拟量表(VAS)评分;记录两组患者术后即刻及术后24 h再次手术意愿;分别于术前5 min和术后即刻采用预期和治疗信任度问卷(expectation and treatment credibility scale,ETCS)评价患者预期与疗效的关系。结果:术中T2、T3时间点观察组MAP、HR低于对照组,SpO2高于对照组(P<0.05),T1时间点两组MAP、HR及Sp O2比较差异无统计学意义(P>0.05)。T2时间点观察组峰值VAS评分及平均VAS评分低于对照组(P<0.05),而在T1、T3时间点组间差异无统计学意义(P>0.05)。观察组术后即刻、术后24 h再次手术意愿高于对照组(P<0.05)。观察组术后即刻ETCS各项评分较术前5 min升高(P<0.05),对照组术前5 min和术后即刻ETCS各项评分比较,差异无统计学意义(P>0.05);术后即刻观察组患者ETCS1、ETCS2和ETCS3评分高于对照组(P<0.05)。结论:腕踝针对椎间孔镜手术患者术中腰痛有确切的辅助镇痛作用,可以增强患者对手术疗效的信心。 Objective To observe the auxiliary analgesic effect of wrist-ankle acupuncture on patients undergoing transforaminal endoscope surgery.Methods A total of 64 patients with lumbar disc herniation who underwent percutaneous lateral transforaminal endoscope surgery were randomly divided into an observation group and a control group,32 cases in each group.The patients in the control group were treated with injection of 1%lidocaine for routine local infiltration anesthesia.The patients in the observation group were treated with wrist-ankle acupuncture at lower 5 area and lower 6 area for 30 min,5 min before routine local infiltration anesthesia;immediately,15 min,30 min after insertion the left-right technique,up-down technique,and rotation technique were applied for six times,respectively.The mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO2)and pain visual analogue scale(VAS)were compared between the two groups at the time points of intraoperative puncture(T1),circular saw grinding(T2),and placement of working channel(T3).The intention of reoperation was recorded immediately after operation and 24 h after operation.The expectation and treatment credibility scale(ETCS)was used to evaluate the relationship between patients’expectation and efficacy 5 min before operation and immediately after operation.Results At T2 and T3 during the operation,the MAP and HR in the obserrvation group were lower than those in the control group,while Sp O2 was higher than that in the control group(P<0.05).At T1,there was no significant difference of MAP,HR and SpO2 between the two groups(P>0.05).At T2,the peak VAS and average VAS in the observation group were lower than those in the control group(P<0.05),but there was no significant difference at T1 and T3(P>0.05).The intention of reoperation in the observation group was higher than that in the control group both immediately after operation and 24 h after operation(P<0.05).In the observation group,the scores of each item in ETCS immediately after operation were hig

关 键 词： 椎间孔镜手术 腰椎间盘突出症 腕踝针 镇痛

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