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耳穴按压减轻女性腹腔镜袖状胃切除术后 PONV 及促进胃肠功能恢复的前瞻性随机对照研究。

Auricular Acupressure in Relieving PONV and Promoting Gastrointestinal Function Recovery in Females After Laparoscopic Sleeve Gastrectomy: A Prospective Randomized Controlled Trial.

机构信息

Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Tianhe District, Guangzhou, Guangdong Province, China.

School of Nursing, Jinan University, No.601, Huangpu Avenue West, Guangzhou, Guangdong Province, China.

出版信息

Obes Surg. 2024 Jun;34(6):2007-2016. doi: 10.1007/s11695-024-07243-z. Epub 2024 Apr 23.

Abstract

BACKGROUND

The role of current pharmacological treatment after laparoscopic sleeve gastrectomy (LSG) is limited. The incidence of postoperative nausea and vomiting (PONV) after LSG remains high. Auricular acupressure (AA) is believed to relieve PONV after laparoscopic surgeries, but its role in patients with obesity after LSG has yet to be confirmed.

METHODS

Ninety-five female patients who underwent LSG were randomized into two groups: AA combined with conventional anti-nausea medication (AA group, 47 patients) or conventional anti-nausea medication group (control group, 48 patients). Index of nausea and vomiting and retching (INVR) scores, postoperative anti-vomiting medication use, time of first anus exhausting, time of first fluid intake, and time of first to get out of bed were collected within 48 h after surgery.

RESULTS

Demographic data of patients in both groups were balanced and comparable. INVR score (F = 7.505, P = 0.007), vomiting score (F = 11.903, P = 0.001), and retching score (F = 12.098, P = 0.001) were significantly lower in the AA group than that in the control group within 48 h postoperatively. Use of metoclopramide was significantly less in the AA group than in the control group (4.7 [5.5]) vs. 8.8 [7.6], P = 0.004); time to first anus exhausting was significantly less in the AA group than in the control group (17.50 [6.00] vs. 20.42 [8.62], P = 0.020).

CONCLUSIONS

AA combined with conventional anti-vomiting agents can alleviate PONV in female patients after LSG, and AA can promote gastrointestinal exhaustion.

TRIAL REGISTRATION

The trial has been registered in the Chinese Clinical Trial Registry (ChiCTR) with the registration no. ChiCTR2100047381 on June 13, 2021.

摘要

背景

腹腔镜袖状胃切除术(LSG)后目前的药物治疗作用有限。LSG 后术后恶心和呕吐(PONV)的发生率仍然很高。耳穴按压(AA)被认为可以减轻腹腔镜手术后的 PONV,但它在 LSG 后肥胖患者中的作用尚未得到证实。

方法

95 名接受 LSG 的女性患者被随机分为两组:AA 联合常规止吐药物(AA 组,47 例)或常规止吐药物组(对照组,48 例)。收集术后 48 小时内恶心和呕吐指数(INVR)评分、术后止吐药物使用、首次肛门排气时间、首次液体摄入时间和首次下床时间。

结果

两组患者的人口统计学数据均衡且可比。INVR 评分(F = 7.505,P = 0.007)、呕吐评分(F = 11.903,P = 0.001)和干呕评分(F = 12.098,P = 0.001)在术后 48 小时内均明显低于对照组。AA 组的甲氧氯普胺使用率明显低于对照组(4.7 [5.5] vs. 8.8 [7.6],P = 0.004);首次肛门排气时间也明显短于对照组(17.50 [6.00] vs. 20.42 [8.62],P = 0.020)。

结论

AA 联合常规止吐药物可减轻 LSG 后女性患者的 PONV,AA 可促进胃肠排空。

试验注册

该试验于 2021 年 6 月 13 日在中国临床试验注册中心(ChiCTR)注册,注册号为 ChiCTR2100047381。

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