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[1]王金法,鮑航行,蔡運火,等.全膝置換圍手術期耳針鎮(zhèn)痛的臨床應用[J].中醫(yī)正骨,2012,24(05):3-6.
　WANG Jin-fa*,BAO Hang-xing,CAI Yun-huo,et al.Application of Auricular acupuncture for Analgesia in Perioperative Period in Total Knee Arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2012,24(05):3-6.
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全膝置換圍手術期耳針鎮(zhèn)痛的臨床應用()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第24卷
期數(shù):
2012年05期
頁碼:
3-6
欄目:
臨床研究
出版日期:
2012-05-20

文章信息/Info

Title:
Application of Auricular acupuncture for Analgesia in Perioperative Period in Total Knee Arthroplasty
作者:
王金法1; 鮑航行1; 蔡運火1; 章建華2; 童培建2
1.浙江中醫(yī)藥大學,浙江 杭州 310053;
2.浙江省中醫(yī)院,浙江 杭州 310006
Author(s):
WANG Jin-fa*; BAO Hang-xing; CAI Yun-huo; ZHANG Jian-hua; TONG Pei-jian.
*Zhejiang University of Chinese Medicine,Hangzhou 310053,Zhejiang,China.
關鍵詞:
關節(jié)成形術; 置換; 膝 耳針 鎮(zhèn)痛; 病人控制
Keywords:
Arthroplasty; Replacement; knee;  Auricular acupuncture;  Analgesia; Patient-Controlled
摘要:
目的:觀察耳針在全膝關節(jié)置換術圍手術期鎮(zhèn)痛的療效。方法:將60例因膝骨性關節(jié)炎晚期行單側(cè)首次全膝關節(jié)置換術的患者被完全隨機分成兩組,耳針組31例,對照組29例。耳針組患者在術前晚予“神門”、“皮質(zhì)下”、“肺”和“膝關節(jié)”四處耳穴埋針,對照組在耳部輪1、2、3、4四處假埋針治療。術后采用直觀模擬疼痛量表評估患者術后疼痛程度; 所有患者術后72 h內(nèi)使用患者自控鎮(zhèn)痛泵,患者每次在模擬疼痛評分﹥4.0時先行耳穴按壓5 min,如疼痛緩解不明顯再行自控鎮(zhèn)痛泵治療。于不同的時間點分別記錄自控鎮(zhèn)痛泵的用量,并記錄術后3 d內(nèi)患者發(fā)生惡心嘔吐、嗜睡等不良反應的情況。結(jié)果:耳針患者在術后12、24、36、48、60、72 h的疼痛評分和術后第1、2、3天自控鎮(zhèn)痛泵使用量均低于對照組且差異有統(tǒng)計學意義; 耳針組術后3 d內(nèi)發(fā)生惡心嘔吐、眩暈嗜睡的例數(shù)少于對照組,差異有統(tǒng)計學意義; 耳針組患者未觀察到任何與耳針治療相關的不良反應。結(jié)論:耳針能減輕全膝關節(jié)置換術后的疼痛,減少鎮(zhèn)痛藥物的用量及術后不良反應的發(fā)生。
Abstract:
Objective:To observe the effect of auricular acupoint(AA)for analgesia during perioperative period in total knee arthroplasty.Methods:60 patients undergoing the first unilateral Total Knee Arthroplasty(TKA)for the terminal knee osteoarthritis(OA)were randomly divided into the Auricular acupuncture(AA)group and the control group,31 in AA group,the other in the control group.At four Acupuncture point on the ear named “shenmen”“thalamus” “l(fā)ung” and“knee joint”,AA group received auricular needle-embedding the before surgery.and the control group received sham needle-embedding in sham acupuncture points.Pain of patients during postoperatively were evaluated with a visual analog scale(VAS); All patients received Patient Controlled Analgesia(PCA)for 72hours after surgery(in the PCA pump,300 mL liquid includes 800 mg tramadol and 0.5mg fentanyl).They were encouraged to stimulate the needles for 5 min every time they experienced pain﹥4.0 score and only after that to inject the PCA pump, if needed.The consumption of analgesia was recorded at each time quantum; The Incidence of postoperative complications was counted during PCA.Results:Compared to the control group,VAS for pain of the patients of AA group had significantly lower to hours 12、24、36、48、60 and 72 after surgery.The consumption of analgesia of AA group during the 1d 2d and 3d after surgery were significant less; The Incidence of nausea or vomiting and dizziness or drowsiness in AA group was significantly less than in the control group during using the PCA pump.Conclusion:In total knee arthroplasty Auricular acupuncture can significantly relieve the postoperative pain of patients and the consumption of patient controlled analgesia,reduce the occurrence of post operative nausea or vomiting and dizziness or drowsiness.

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更新日期/Last Update: 2012-05-20