隔姜灸联合腕踝针治疗原发性肝癌TACE术后呕吐的临床护理疗效观察研究

Clinical Nursing Efficacy of Ginger-Separated Moxibustion Combined with Wrist-Ankle Acupuncture on Postoperative Vomiting in Patients with Primary Liver Cancer Undergoing TACE

摘要: 目的：观察隔姜灸联合腕踝针对原发性肝癌TACE术后恶心呕吐的预防效果及对生活质量的影响。方法：选取行TACE术的原发性肝癌患者60例，随机分为对照组和观察组，各30例。对照组行术后常规护理及止吐对症处理，观察组加用隔姜灸联合腕踝针干预，每日1次，连续7 d。比较两组术后恶心呕吐发生率、WHO分级、FLIE生活质量评分及不良反应。结果：观察组术后1、3、5 d恶心呕吐发生率(33.33%、23.33%、16.67%)均显著低于对照组(60.00%、50.00%、40.00%)，差异有统计学意义(P < 0.05)；术后7 d两组差异无统计学意义(P > 0.05)。观察组呕吐控制分级优于对照组(Z = −2.193, P = 0.028)。观察组FLIE总分(124.30 ± 14.76)显著高于对照组(102.60 ± 18.45)，NIDL比例(70.00%)高于对照组(40.00%)，差异均有统计学意义(P < 0.05)。两组不良反应发生率均低(6.67% vs 3.33%)，差异无统计学意义(P > 0.05)。结论：隔姜灸联合腕踝针可有效降低肝癌TACE术后恶心呕吐发生率，改善患者生活质量，安全性好，值得临床推广。

Abstract: Objective: To observe the preventive effect of ginger-separated moxibustion combined with wrist-ankle acupuncture on postoperative nausea and vomiting (PONV) in patients with primary liver cancer undergoing transcatheter arterial chemoembolization (TACE) and its impact on quality of life. Methods: A total of 60 patients with primary liver cancer who underwent TACE were randomly divided into a control group and an observation group, with 30 cases in each group. The control group received routine postoperative nursing care and symptomatic antiemetic treatment, while the observation group received additional intervention of ginger-separated moxibustion combined with wrist-ankle acupuncture, once daily for 7 consecutive days. The incidence of postoperative nausea and vomiting, WHO vomiting grading, Functional Living Index-Emesis (FLIE) quality of life scores, and adverse reactions were compared between the two groups. Results: The incidences of nausea and vomiting in the observation group at 1, 3, and 5 days postoperatively (33.33%, 23.33%, and 16.67%, respectively) were significantly lower than those in the control group (60.00%, 50.00%, and 40.00%, respectively), with statistically significant differences (P < 0.05); no statistically significant difference was observed between the two groups at 7 days postoperatively (P > 0.05). The vomiting control grading in the observation group was superior to that in the control group (Z = −2.193, P = 0.028). The total FLIE score in the observation group (124.30 ± 14.76) was significantly higher than that in the control group (102.60 ± 18.45), and the proportion of patients with “no impact on daily living” (NIDL) in the observation group (70.00%) was higher than that in the control group (40.00%), with both differences being statistically significant (P < 0.05). The incidence of adverse reactions was low in both groups (6.67% vs. 3.33%), with no statistically significant difference (P > 0.05). Conclusion: Ginger-separated moxibustion combined with wrist-ankle acupuncture can effectively reduce the incidence of postoperative nausea and vomiting in patients with liver cancer undergoing TACE, improve patients’ quality of life, and exhibits good safety, warranting clinical promotion.