耳穴压豆联合右美托咪定穴位注射对老年患者脊柱术后谵妄的影响

发布时间：2018-05-31 11:32

本文选题：脊柱/中西医结合疗法 + 耳穴　；参考：《陕西中医》2016年12期

【摘要】：目的:探讨耳穴压豆联合右美托咪定穴位注射对老年患者脊柱术后谵妄发生率与生活质量的影响。方法:82例行脊柱手术老年患者按照随机数字表法分为观察组(耳穴压豆联合右美托嘧啶双侧神门穴注射)和对照组(常规治疗)。采用汉密尔顿焦虑量表(HAMA)、视觉模拟量表法(VAS)、匹兹堡睡眠质量指数问卷(PSQI)、意识错乱评估方法(CAM)测评两组的焦虑、术后疼痛、睡眠、意识状况。结果:观察组术后3d谵妄的累计发生率(3/41,7.3%)低于对照组(10/41,24.4%)。观察者的HAMA(12.5±7.5vs 20.2±9.8)、疼痛VAS得分(2.9±1.2vs 4.1±1.0)低于对照组,其恶心呕吐的发生率低于对照组(6/41,19.5%vs14/41,34.1%)。术后,观察组的睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍、PSQI总分显著低于对照组。结论:耳穴压豆联合右美托咪定穴位注射可有效降低老年患者脊柱术后谵妄的发生率,缓解术后焦虑、疼痛,改善患者睡眠质量。
[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 卤7.5vs 20. 2 卤9. 8 and the VAS score of pain (2. 9 卤1.2vs 4. 1 卤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.
【作者单位】：广东省江门市五邑中医院麻醉科;
【基金】：广东省江门市第三批科技计划项目[(2015)75号-12]
【分类号】：R614

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