子宫输卵管造影术相关疼痛影响因素分析及耳穴压丸应用研究

发布时间：2018-12-18 16:31

【摘要】：目的:前瞻性地分析子宫输卵管造影术相关疼痛的影响因素,观察耳穴压丸运用于子宫输卵管造影术的止痛效果,以指导临床研究。方法:采用随机对照的实验方法,将符合纳入标准的研究对象180名,随机分为耳穴组91名,安慰组89名。耳穴组采用王不留行籽贴压双侧神门、皮质下、内分泌、子宫等穴位,并嘱患者造影术前15min以拇指、食指对压耳穴,每个穴位以60-80次/min的频率进行按压,每五分钟按压一次,每次持续1分钟,双侧交替,术后以同样方式按压15min。安慰组在上述耳穴位置敷贴外形、数量相同的胶布,不予任何刺激。术前医生填写调查表,记录患者不孕类型、既往分娩方式、学历背景、痛经史、手术史等资料。术后患者自评分,分别记录子宫输卵管造影术器械操作、对比剂注入、术后30分钟时的VAS评分。分析子宫输卵管造影相关疼痛影响因素,观察比较三个不同操作时期VAS评分差异,并比较耳穴组与安慰组VAS评分、术后不良反应率的差异。结果:(1)子宫输卵管造影相关疼痛特点:对比剂注入时VAS评分最高,器械操作时次之,术后30min最低,组间比较差异显著,且有统计学意义(P值均小于0.01)。(2)子宫输卵管造影相关疼痛影响因素:对比剂注入时,继发不孕患者VAS评分显著低于原发不孕患者,差异有统计学意义(P0.01);顺产患者VAS评分低于剖腹产、流产、宫外孕患者,差异有统计学意义(P0.05)。HSG造影结果异常患者在术后30min时VAS评分高于造影结果正常患者,差异有统计学意义(P0.05)。学历背景、痛经史、腹盆部手术或感染史等比较差异无统计学意义(P0.05)。(3)耳穴压丸组止痛疗效观察:子宫输卵管造影三个不同操作时期,耳穴组VAS评分均低于安慰组,差异有统计学意义(P0.05)。结论:子宫输卵管造影相关疼痛在对比剂注入时程度最剧烈;既往分娩方式、不孕类型、HSG造影结果是HSG相关疼痛影响因素;耳穴压丸法可在一定程度上缓解HSG相关疼痛,并降低术后不良反应率。
[Abstract]:Objective: to prospectively analyze the factors influencing the pain associated with hysterosalpingography and to observe the analgesic effect of auricular acupoint compression pill in hysterosalpingography in order to guide the clinical study. Methods: 180 subjects were randomly divided into auricular point group (n = 91) and comfort group (n = 89). The auricular acupoints group were pressed by Wang Buliu seed sticking, pressing bilateral acupoints such as Shenmen, subcortex, endocrine, uterus and so on. The patients were told to press the auricular points with thumb and index finger before contrast radiography with 60 to 80 times per min per acupoint. Press once every five minutes, 1 minute each time, alternately bilateral, press 15 minutes in the same way after operation. Comfort group in the above-mentioned auricular point application shape, the same amount of tape, no stimulation. Before operation, doctors filled out questionnaires to record the type of infertility, previous delivery style, educational background, dysmenorrhea history, surgical history and so on. The operation of hysterosalpingography instruments, injection of contrast media, and VAS score 30 minutes after operation were recorded. To analyze the influencing factors of hysterosalpingography related pain, to observe and compare the difference of VAS score in three different operation periods, and to compare the difference of VAS score between auricular acupoint group and comfort group, and the rate of adverse reaction after operation. Results: (1) the characteristics of hysterosalpingography related pain: the VAS score was the highest when the contrast agent was injected, the second was when the instrument was operated, the 30min was the lowest after operation, and the difference between the groups was significant. There were statistically significant (P < 0. 01). (2) factors affecting the pain associated with hysterosalpingography: the VAS score of the infertile patients with secondary infertility was significantly lower than that of the patients with primary infertility when the contrast agent was injected. The difference was statistically significant (P0.01). The VAS score of patients with spontaneous delivery was lower than that of patients with cesarean section, abortion and ectopic pregnancy, the difference was statistically significant (P0.05) the VAS score of patients with abnormal). HSG results was higher than that of patients with normal 30min results after operation. The difference was statistically significant (P0.05). Educational background, history of dysmenorrhea, history of abdominal and pelvic surgery or infection were not significantly different (P0.05). (3) observation of analgesic effect in auricular acupoint pressing pill group: hysterosalpingography was performed in three different stages. The VAS score of auricular acupoint group was lower than that of comfort group, the difference was statistically significant (P0.05). Conclusion: hysterosalpingography associated pain is the most severe in contrast medium injection, previous delivery mode, type of infertility, and HSG findings are the influencing factors of HSG related pain. Auricular acupoint pressing pill can relieve HSG-related pain to some extent and reduce the rate of postoperative adverse reactions.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.6;R816.91

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