【作者】 曾艳芳；

【导师】 吴丹妮； 宫毅；

【作者基本信息】 云南中医学院 ， 中医外科学（专业学位）， 2014， 硕士

【摘要】 目的：混合痔外剥内扎术后对运用电针及亚甲蓝镇痛的疗效对比。方法：对混合痔外剥内扎术后电针治疗的35例治疗组患者及亚甲蓝组长效麻醉剂局部浸润治疗的30例对照组患者，行术后排便疼痛VAS评分、疼痛缓解度、手术后24小时疼痛持续时间、疼痛出现时间、疼痛基本消失时间（即VAS≤2）、术后镇痛的总体疗效及术后治疗期间不良反应比较评估。同时记录术前VAS评分、术后1、2、3、5、7天疼痛的VAS评分、术后24小时疼痛持续时间的VAS评分、镇痛总体疗效评分及尿潴留、恶心、便秘等不良反应例数，依照视觉模拟评分（VAS）及疼痛缓解度公式算出疼痛缓解度。结果：（1）术后第1、2、3、5天两组排便时疼痛评分，分别由2检验，P=0.000<0.05，有非常显著差异，其中术后第7天P=0.003<0.05，有显著差异。治疗组镇痛优于对照组，两组比较具有统计学意义（P<0.05）。（2）与第1天相比，术后第2天、第3天、第5天疼痛缓解度经2检验，P值分别为0.041、0.037、0.045均小于0.05，有差异但不显著。其中术后第7天经2检验，P=0.029<0.01，说明治疗组优于对照组，镇痛效果好。（3）治疗后24小时疼痛持续时间VAS评分，经2检验，P=0.007<0.05，比较对照组，治疗组缩短了术后24小时疼痛持续时间。（4）治疗后疼痛发生时间2=10.704，P=0.152>0.05；两组疼痛基本消失时间2=38.145，P=0.002<0.05；两组术后疼痛出现时间无差异，两组疼痛基本消失时间有显著性差异。（5）镇痛总体疗效评定：35例治疗组的总有效率为97.14%，其中显效30例，有效4例，无效1例；30例对照组的总有效率为80%，其中显效13例，有效11例，无效6例。经统计学分析，2=14.649，P=0.001<0.05，治疗组镇痛总体疗效比对照组明显改善。（6）不良反应：35例治疗组患者术后不良反应中，恶心0例、尿潴留2例、便秘1例；30例对照组病人术后出现恶心4例、尿潴留5例、便秘4例，治疗组不良反应发生例数明显低于对照组。结论：混合痔外剥内扎术后电针组镇痛疗效优于亚甲蓝组，明显缩短术后疼痛持续时间，减少不良反应的发生，是值得临床推广的有效止痛方法。更多还原

【Abstract】 Objective: mixed hemorrhoid external strip after Mr. To use electric acupuncture and methyleneblue analgesic efficacy.Method: the mixed hemorrhoid external strip after Mr. Cupping treatment of35patients intreatment group and long-acting narcotic in methylene blue group.Line infiltration treatment of30cases of control group, postoperative pain, pain relief and24hours after defecate constant painTime to time, pain, pain disappeared basically time (i.e., VAS2or less), the overall curative effectand postoperative treatment of postoperative analgesia.Adverse reactions compared assessmentduring treatment. At the same time record the preoperative and postoperative1,2,3,5,7days ofpain VAS score,Postoperative24hours duration of pain VAS scores and analgesic effect overallscore and urine chuhe, nausea, constipation, etc.Adverse reaction cases, according to the visualanalogue scale (VAS) and the degree of pain relief formula to calculate the degree of pain relief.Results:(1)1,2,3,5days in the two groups during defecation pain score, respectively by twoinspection, P=0.000<0.05, there is a very significant difference, the postoperative day7(P=0.003<0.05, significant differences. Analgesic treatment group is better than that of control group,two groups are statistically significant (P <0.05).(2) compared with1day,2days,3days,5days degree of pain relief after2test, P valueswere0.041,0.037,0.045, less than0.05, but not significant difference. The postoperative day7checked by2, P=0.029<0.01, suggesting that the treatment group is better than that of controlgroup, analgesic effect is good.(3) the duration of postoperative pain24hours VAS score, checked by2, P=0.007<0.05,the treatment group pain time shorter than the control group24hours after surgery.(4) postoperative pain occurred2=10.704, P=0.152>0.05; Two groups of paindisappeared basically time2=38.145, P=0.002<0.05.(5) analgesia overall curative effect evaluation:35cases in treatment group total effectiverate was97.14%, in which30cases were markedly effective, effective4cases,1had no effect;30cases in the control group total effective rate was80%, of which13cases were markedly effective, effective in11cases, invalid6cases. After statistics analysis,2=14.649, P=0.001<0.05, thetreatment group analgesic efficacy than the control group obviously improved as a whole.(6) Adverse reactions:35cases in treatment group patients postoperative adversereactions, nausea0cases, urine chuhe stay in2cases,1cases of constipation;30cases ofcontrol group patients postoperative nausea in4cases, urinary chuhe5cases,4cases wereconstipation.Conclusion: in mixed hemorrhoid external strip firm postoperative analgesic effect of electricacupuncture group is better than that of methylene blue group, significantly shorten the duration ofpostoperative pain and reduce the occurrence of adverse reactions, is worthy of clinical promotioneffective analgesic method.更多还原