【摘要】：目的:通過本次研究,評價四關(guān)穴電針刺激應(yīng)用于甲狀腺手術(shù)后鎮(zhèn)痛的療效性及安全性,為其廣泛應(yīng)用于甲狀腺術(shù)后鎮(zhèn)痛的臨床治療提供科學(xué)依據(jù),更好地指導(dǎo)中西醫(yī)臨床實踐。方法:參照納入標(biāo)準(zhǔn)在廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院收集自2016年7月至2017年3月期間住院行甲狀腺外科手術(shù)后發(fā)生疼痛的患者60例,運用系統(tǒng)隨機分為實驗組(四關(guān)穴電針刺激組)和對照組(常規(guī)對照組),各30例。在常規(guī)外科術(shù)后護理的基礎(chǔ)上,實驗組患者在手術(shù)結(jié)束安返病房后給予第1次針刺四關(guān)穴加電(疏密波,頻率:2Hz/100Hz)治療,時間為30分鐘,8h后給予第2次治療,2次為1療程。對照組則予常規(guī)外科術(shù)后護理。所有組患者于術(shù)后當(dāng)天(即麻醉清醒后首次訴疼痛時)、術(shù)后4h、12h、24h進行疼痛VAS模擬評分;于術(shù)后當(dāng)天(即麻醉清醒后首次訴疼痛時)與術(shù)后24h行布氏舒適度評分;全部數(shù)據(jù)結(jié)果采用SPSS 20.0統(tǒng)計軟件進行分析。結(jié)果:1.實驗組患者術(shù)后各觀察時點的疼痛VAS模擬評分均低于常規(guī)對照組,經(jīng)統(tǒng)計學(xué)檢驗,差別有顯著意義;此外,實驗組患者經(jīng)治療愈顯率為80.76%,顯著高于對照組的53.57%,經(jīng)統(tǒng)計學(xué)檢驗,差異有顯著意義。上述表明:電針?biāo)年P(guān)穴可有效緩解患者甲狀腺術(shù)后的疼痛癥狀。2.實驗組患者在治療結(jié)束后BSC評分為2.55±0.51,而對照組則為1.21 ±0.57,經(jīng)統(tǒng)計學(xué)檢測,差異有顯著的統(tǒng)計學(xué)意義,提示電針?biāo)年P(guān)穴可有效提高患者甲狀腺術(shù)后的舒適狀態(tài)。結(jié)論:四關(guān)穴電針刺激在甲狀腺術(shù)后鎮(zhèn)痛管理中療效顯著,其治療過程安全、不良反應(yīng)少,值得在臨床推廣應(yīng)用。
[Abstract]:Objective: to evaluate the efficacy and safety of electroacupuncture stimulation at Siguan point for postoperative analgesia after thyroid surgery, and to provide scientific basis for its wide application in the clinical treatment of postoperative analgesia of thyroid gland. Better guide the clinical practice of traditional Chinese and western medicine. Methods: according to the inclusion criteria, 60 patients with postoperative pain after thyroid surgery were collected from July 2016 to March 2017 in the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine. The experimental group (Siguan acupoint electroacupuncture stimulation group) and the control group (conventional control group) were randomly divided into two groups: 30 cases each. On the basis of routine postoperative nursing care, the patients in the experimental group were treated with the first acupuncture at Siguan point plus electricity (density wave, frequency: 2 Hz / 100 Hz) at the end of the operation, and the second treatment was given twice as a course of treatment after 8 hours for 30 minutes. The control group was given routine postoperative nursing care. All the patients in all groups were assessed with VAS on the day after operation (i.e. the first complaint of pain after anaesthesia), and with Brinell comfort score on the day of operation (that is, the first complaint of pain after anaesthesia) and 24 hours after the operation, 4 hours after the operation, 12 hours after the operation and 24 hours after the operation. All the data were analyzed by SPSS 20.0 software. The result is 1: 1. The VAS analogue score of pain in the experimental group was lower than that in the control group after operation, and the difference was statistically significant. In addition, the curative effect rate of the patients in the experimental group was 80.76g, which was significantly higher than that in the control group (53.57g). The difference was significant. The above results indicate that electroacupuncture at Siguan points can effectively relieve the pain symptoms. 2. 2. The BSC score of the experimental group was 2.55 鹵0.51 after treatment, while that of the control group was 1.21 鹵0.57.The difference was statistically significant, suggesting that electroacupuncture at Siguan point could effectively improve the comfort state of the patients after thyroidectomy. Conclusion: electroacupuncture stimulation at Siguan point is effective in postoperative analgesia management of thyroid, and its treatment process is safe and has less adverse reactions, so it is worth popularizing in clinic.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R653

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