内关穴经皮穴位电刺激防治甲状腺肿瘤术后恶心呕吐疗效的临床观察

目的观察内关穴经皮穴位电刺激（transcutaneous acupoint electrical stimulation，TAES）和静脉或内关穴注射氟哌利多用于防治甲状腺术后恶心呕吐（post operative nausea and vomiting，PONV）的临床疗效。方法择期行甲状腺肿瘤手术的女性患者120例，随机分为对照组、TAES组、静脉注射组及穴位注射组，每组30例。在麻醉诱导前30 min，对照组给予静脉注射0.9%氯化钠注射液2 mL；TAES组行双侧内关穴TAES；静脉注射组和穴位注射组分别行氟哌利多2.5 mg（1 mL）加0.9%氯化钠注射液1 mL静脉注射或双侧内关穴注射。观察术后6 h内和术后6～24 h PONV的发生率及严重程度。结果 与对照组比较，TAES组、静脉注射组和穴位注射组术后6 h内及6～24 h PONV发生率及严重程度均显著降低（P<0.05）。3个治疗组PONV发生率及严重程度比较，差异均无统计学意义（P>0.05）。结论 内关穴TAES能显著降低甲状腺手术PONV的发生率和严重程度，且与内关穴或静脉注射氟哌利多效果相当。

英文摘要:

Objective To observe the clinical efficacy of transcutaneous acupoint electrical stimulation （TAES） combined intravenous injection and/or Neiguan （P6） injection with droperidol in preventing and treating post operative nausea and vomiting （PONV） after thyroid tumor surgery. Methods Recruited were 120 female patients who underwent selective thyroid tumor surgery were randomly assigned to the control group， the TAES group， the IV group （intravenous injection of droperidol）， and the P6 group ［Neiguan point （P6） injection of droperidol］， respectively， 30 cases in each group. Thirty min before anesthesia induction， 2 mL 0.9% normal saline injection was intravenously injected to those in the control group. Patients in the TAES group received TEAS at bilateral P6 points. 2.5 mg （1 mL） droperidol added in 1 mL 0.9 normal saline was intravenously injected to those in the IV group and injected at bilateral P6 points of those in the P6 group. The occurrence and severity of PONV were observed within 0－6 h and within 6－24 h after operation in each group. Results Compared with the control group， the incidence and the severity of PONV within 0－6 h and within 6－24 h after thyroid surgery were significantly reduced in the three treatment groups （P<0.05）. There was no statistical difference in the incidence or the severity of PONV among the TAES， IV and P6 groups （P>0.05）. Conclusions TEAS at P6 could dramatically reduce the occurrence and the severity of PONV after thyroid tumor surgery. Besides， it got equivalent effect to that by intravenous injecting droperidol or by injecting droperidol at P6.

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