本文選題：脊柱/中西醫(yī)結合療法 + 耳穴　； 參考：《陜西中醫(yī)》2016年12期

【摘要】：目的:探討耳穴壓豆聯合右美托咪定穴位注射對老年患者脊柱術后譫妄發(fā)生率與生活質量的影響。方法:82例行脊柱手術老年患者按照隨機數字表法分為觀察組(耳穴壓豆聯合右美托嘧啶雙側神門穴注射)和對照組(常規(guī)治療)。采用漢密爾頓焦慮量表(HAMA)、視覺模擬量表法(VAS)、匹茲堡睡眠質量指數問卷(PSQI)、意識錯亂評估方法(CAM)測評兩組的焦慮、術后疼痛、睡眠、意識狀況。結果:觀察組術后3d譫妄的累計發(fā)生率(3/41,7.3%)低于對照組(10/41,24.4%)。觀察者的HAMA(12.5±7.5vs 20.2±9.8)、疼痛VAS得分(2.9±1.2vs 4.1±1.0)低于對照組,其惡心嘔吐的發(fā)生率低于對照組(6/41,19.5%vs14/41,34.1%)。術后,觀察組的睡眠質量、入睡時間、睡眠時間、睡眠效率、睡眠障礙、日間功能障礙、PSQI總分顯著低于對照組。結論:耳穴壓豆聯合右美托咪定穴位注射可有效降低老年患者脊柱術后譫妄的發(fā)生率,緩解術后焦慮、疼痛,改善患者睡眠質量。
[Abstract]:Objective: to investigate the effect of auricular acupoint injection with dexmetomidine on the incidence of delirium and quality of life (QOL) in elderly patients after spinal surgery. Methods Eighty-two elderly patients undergoing spinal surgery were randomly divided into observation group (auricular acupoint injection) and control group (routine therapy). The anxiety, postoperative pain, sleep and consciousness of the two groups were evaluated by Hamilton anxiety scale (Hama), visual analogue scale (VAS), Pittsburgh Sleep quality Index (PSQI) and consciousness disorder (CAM). Results: the cumulative incidence of delirium 3 days after operation in the observation group was lower than that in the control group. The HAMA(12.5 鹵7.5vs 20. 2 鹵9. 8 and the VAS score of pain (2. 9 鹵1.2vs 4. 1 鹵1. 0) were lower than those in the control group. The incidence of nausea and vomiting was lower than that in the control group. The incidence of nausea and vomiting was significantly lower than that in the control group. After operation, the total scores of sleep quality, sleep time, sleep efficiency, sleep disorder and daytime dysfunction in the observation group were significantly lower than those in the control group. Conclusion: Auricular acupoint injection combined with dexmetomidine can effectively reduce the incidence of postoperative delirium, relieve postoperative anxiety and pain, and improve the sleep quality of elderly patients.
【作者單位】： 廣東省江門市五邑中醫(yī)院麻醉科;
【基金】：廣東省江門市第三批科技計劃項目[(2015)75號-12]
【分類號】：R614

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