颊针及颊针联合昂丹司琼在女性患者全麻腹腔镜胆囊切除术中的应用效果

The Efficacy of Cheek Acupuncture and Its Combination with Ondansetron in Female Patients Undergoing Laparoscopic Cholecystectomy with General Anesthesia

摘要: 目的：评价颊针及颊针联合昂丹司琼在女性患者腹腔镜胆囊切除术的使用效果。方法：将腹腔镜下胆囊切除术的女性患者98例随机分为昂丹司琼组(A组)、颊针组(B组)和颊针联合昂丹司琼组(C组)，观察术后24小时中重度疼痛发生率、术后恶心呕吐发生率、视觉模拟评分(VAS)、麻醉药物用量、术后补救镇痛和止吐药物使用情况、围手术期不良事件发生率、首次排气时间和术后出院时间。结果：术后0~24小时中重度疼痛发生率分别为A组40.6%、B组11.8%、C组12.5%，B组、C组与A组相比差异有统计学意义(P = 0.007, P = 0.011)。三组术后6~12小时的VAS评分差异有统计学意义(P = 0.000)。术后补救性镇痛药物使用率，A组、B组、C组分别为28.1%，2.9%，9.4%，B组与A组存在统计学差异(P = 0.005)。A组、B组、C组术后0~24小时PONV发生率分别为34.4%、14.7%和31.3%，组间无统计学差异(P = 0.148)。结论：颊针或颊针联合昂丹司琼均可有效降低女性患者腹腔镜胆囊切除术术后中重度疼痛的发生率，颊针而非颊针联合昂丹司琼具有更低的术后补救镇痛药物使用率；颊针联合昂丹司琼在降低PONV发生率方面并不优于颊针。

Abstract: Objective: To evaluate the efficacy of cheek acupuncture and cheek acupuncture combined with ondansetron in female patients undergoing laparoscopic cholecystectomy. Methods: 98 female patients undergoing laparoscopic cholecystectomy were randomly divided into the ondansetron group (Group A), cheek acupuncture group (Group B), and cheek acupuncture combined with ondansetron group (Group C). The incidence of moderate-to-severe pain within 24 hours postoperatively, postoperative nausea and vomiting (PONV), Visual Analog Scale (VAS) scores, anesthetic dosage, postoperative remedial analgesic and antiemetic drug usage, the incidence of perioperative adverse events, time to first flatus, and postoperative discharge time were observed. Results: The incidence of moderate-to-severe pain within 0~24 hours postoperatively was 40.6% in Group A, 11.8% in Group B, and 12.5% in Group C；Both Group B and Group C showed statistically significant differences compared with Group A (P = 0.007, P = 0.011, respectively). VAS scores differed significantly among the three groups at 6~12 hours postoperatively (P = 0.000). The usage rates of postoperative rescue analgesics were 28.1%, 2.9%, and 9.4% in Groups A, B, and C, respectively, with a statistically significant difference between Group B and Group A (P = 0.005). The incidence of PONV within 0~24 hours postoperatively was 34.4%, 14.7%, and 31.3% in Groups A, B, and C, with no statistical difference among groups (P = 0.148). Conclusion: Cheek acupuncture alone or combined with ondansetron effectively reduces the incidence of moderate-to-severe postoperative pain in female patients undergoing laparoscopic cholecystectomy. Cheek acupuncture alone but not the combination therapy has a lower rate of postoperative rescue analgesic usage compared with ondansetron. Cheek acupuncture combined with ondansetron is not superior to cheek acupuncture alone in reducing the incidence of PONV.