围术期颊针治疗对老年全髋关节置换老年患者术后睡眠及疼痛的影响

黄 翠芳, 赵 路远, 黄 世峰, 杨 鲜妮, 武 贵林
中国人民解放军联勤保障部队第九二三医院　麻醉科

摘要


目的：探讨颊针对接受全髋关节置换术老年患者睡眠质量及术后疼痛的影响。方法：选择172例接受THA老年患者，随机分为颊针组（BA组）和假颊针组（SA组）每组86例。BA组患者于麻醉诱导前20分钟、术后1-3天接受颊针治疗。SA组患者接受假针刺治疗（使用钝针头，不刺破皮肤）。使用多导睡眠监测仪（PSG）和采用匹兹堡睡眠质量指数（PSQI）评估夜间睡眠情况。记录术后24、48及72小时视觉模拟评分（VAS），术后镇痛泵按压次数及补救镇痛例数，检测术后1、3天血清白细胞介素（IL）-6和C反应蛋白（CRP）水平和记录术后72 h内不良反应。结果：与术前比较，两组术后第1、3天入睡潜伏期（SL）明显延长，总睡眠时间（TST）明显缩短，睡眠效率（SE）明显降低，快动眼睡眠时间在总睡眠时间中所占的百分比（REM%）明显降低（P＜0.05）。与SA组比较，BA组术后第1、3天SL显著缩短，TST显著延长，SE显著增大，术后第1天REM%显著增加，BA组PSQI评分、术后睡眠障碍（PSD）发生率、术后72h活动VAS评分、镇痛泵按压次数、补救用药次数及剂量、血清IL-6和CRP水平显著降低，术后72h内术后恶心呕吐、嗜睡不良反应发生情况显著降低（均P＜0.05）。结论：围手术期颊针干预能够有效改善THA术后老年患者的睡眠障碍，可能与颊针治疗减轻术后疼痛及发挥抗炎作用有关。

关键词


颊针；术后睡眠；术后睡眠障碍；术后疼痛；全髋关节置换术；老年

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参考


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