针刺疗法对胸骨正中切口心脏手术患者术后远期疼痛的影响
Effect of acupuncture therapy on long-term postoperative pain in patients undergoing cardiac surgery with median sternotomy
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摘要:目的 探讨针刺疗法对胸骨正中切口心脏手术患者术后远期疼痛的影响。方法 选取120例胸骨正中切口心脏手术患者作为研究对象, 采用随机数字表法分为对照组和针刺组, 每组60例。对照组术后采用常规处理, 针刺组在常规处理基础上采用针刺疗法。比较2组患者术后镇痛药物用量和术后恢复情况, 比较2组患者手术前后C反应蛋白(CRP)、T细胞亚群水平, 比较2组患者围术期和术后远期疼痛评分。结果 针刺组术后3 d、7 d、1个月、3个月的镇痛药物用量均少于对照组, 差异有统计学意义(P < 0.05)。术前, 2组CRP、T细胞亚群水平比较, 差异无统计学意义(P>0.05); 术后5 d时, 2组CRP、CD8+水平均高于术前, CD4+、CD4+/CD8+水平均低于术前, 但针刺组CRP、CD8+水平低于对照组, CD4+、CD4+/CD8+水平高于对照组, 差异有统计学意义(P < 0.05)。针刺组术后生活质量评分高于对照组, 围术期和术后远期疼痛评分均低于对照组, 差异有统计学意义(P < 0.05); 2组平均住院时间、术后并发症发生率比较, 差异无统计学意义(P>0.05)。结论 针刺疗法可显著缓解胸骨正中切口心脏手术患者围术期疼痛和术后远期疼痛, 减少镇痛药物用量, 提高患者生活质量, 且不会增加并发症的发生。Abstract:Objective To explore the effect of acupuncture therapy on long-term postoperative pain in patients undergoing cardiac surgery through median sternal incision.Methods A total of 120 patients undergoing cardiac surgery with median sternal incision were selected as study objects, and were randomly divided into control group (n=60) and acupuncture group (n=60). The former was treated with conventional treatment after surgery, while the latter group was treated with acupuncture therapy on the basis of conventional treatment. Postoperative analgesic drug dosage and postoperative recovery were compared between the two groups, and the levels of C-reactive protein (CRP) and T cell subsets before and after surgery were compared between the two groups. In addition, perioperative and postoperative long-term pain scores were also compared between the two groups.Results The dosage of analgesic drugs in the acupuncture group was lower than that in the control group at 3 d, 7 d, 1 month and 3 months after operation, and the differences were statistically significant (P < 0.05). Before surgery, there was no significant difference in CRP and T cell subsets between two groups (P>0.05). At 5 days after surgery, CRP and CD8+ levels in two groups were higher than before surgery, and CD4+ and CD4+/CD8+ levels were lower than before surgery, but the CRP and CD8+ levels in the acupuncture group were lower than those of the control group, and CD4+ and CD4+/CD8+ levels were higher than those in the control group (P < 0.05). The quality of life in the acupuncture group were higher than those in the control group, the perioperative and postoperative long-term pain scores of the acupuncture group were significantly lower than those of the control group, and the differences were statistically significant (P < 0.05). However, the mean length of stay and incidence of postoperative complications showed no significant differences between the two groups(P>0.05).Conclusion Acupuncture therapy can significantly relieve the perioperative pain and long-term postoperative pain of patients with median sternal incision.
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