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| 揿针疗法防治腹腔镜胆囊切除术后高风险患者恶心呕吐的效果研究 |
| Effect of Press Needle TheraPy on Preventing Nausea and Vomiting in High-Risk Patients after LaParoscoPic Cholecystectomy |
| 投稿时间：2026-06-02 修订日期：2026-06-26 |
| DOI： |
| 中文关键词: 揿针 腹腔镜胆囊切除术 术后恶心呕吐 |
| 英文关键词:Thumb-tack needle Laparoscopic cholecystectomy Postoperative nausea and vomiting |
| 基金项目:上海市松江区科技攻关（医疗卫生类）项目（2023SJKJGG030） |
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| 中文摘要: |
| 目的? 探讨揿针预防及减轻胆囊切除术后高风险患者术后恶心呕吐的临床疗效。方法? 采用随机对照试验设计,将2024年7月至2025年5月于上海市某二级甲等中医医院普外科行腹腔镜胆囊切除术恶心呕吐高风险患者166例,通过随机数字表法分为治疗组和对照组,各83例。两组均采用术后常规护理方法,治疗组在对照组的基础上给予内关、合谷、足三里穴揿针治疗,留针48h。观察两组术后0-12h、12-24h、24-48h的恶心呕吐发生程度及术后首次排气时间、术后首次排便时间、术后出院时间的情况。结果? 最终治疗组和对照组各82例患者完成研究。在术后0-12h及12-24h,两组恶心呕吐严重程度分布差异有统计学意义(χ2值分别为10.75与14.91,P值分别为0.013与＜0.001),且治疗组Ⅰ级恶心呕吐占比(61.0%、95.1%)高于对照组(42.7%、73.2%)。至术后24-48h,两组差异无统计学意义(χ2=0.51,P=0.477)。此外,两组术后首次排气时间、术后首次排便时间、术后出院时间差异均无统计学意义(均P＞0.05)。研究期间,两组均无不良事件发生。结论? 揿针可有效防治腹腔镜胆囊切除术后高风险患者恶心呕吐的发生程度,为护士在PONV高风险患者中规范应用内关、合谷、足三里穴位的揿针技术提供了证据和操作指南。 |
| 英文摘要: |
| Objective? To evaluate the clinical efficacy of thumb-tack needle (press needle) therapy in preventing and alleviating postoperative nausea and vomiting (PONV) in high-risk patients after laparoscopic cholecystectomy.Methods? A randomized controlled trial was conducted. From July 2024 to May 2025, 166 high-risk PONV patients scheduled for laparoscopic cholecystectomy in the Department of General Surgery at a second-class grade A traditional Chinese medicine hospital in Shanghai were enrolled and randomly assigned via a random number table to either a treatment group or a control group, with 83 patients in each group. Both groups received routine postoperative care. The treatment group additionally received thumb-tack needle application at the Neiguan (PC6), Hegu (LI4), and Zusanli (ST36) acupoints, with needles retained for 48 hours. The observed outcomes included the severity of nausea and vomiting at 0-12h, 12-24h, and 24-48h postoperatively, as well as the time to first flatus, time to first defecation, and length of postoperative hospital stay.Results? Ultimately,82 patients in each group completed the study. The distribution of PONV severity differed significantly between the two groups at 0-12 h (χ2 = 10.75, P = 0.013) and 12-24 h (χ2 = 14.91, P < 0.001) postoperatively. The proportion of patients with Grade I nausea and vomiting was higher in the treatment group (61.0%, 95.1%) compared to the control group (42.7%, 73.2%) at these time points, respectively. By 24-48h postoperatively, no significant difference was found between the groups (χ2 = 0.51, P = 0.477). Furthermore, no statistically significant differences were observed between the two groups in the time to first flatus, time to first defecation, or length of postoperative hospital stay (all P > 0.05). No adverse events were reported in either group during the study.Conclusion? Thumb-tack needle therapy at Neiguan (PC6), Hegu (LI4), and Zusanli (ST36) acupoints effectively prevents and reduces the severity of PONV in high-risk patients undergoing laparoscopic cholecystectomy. This study provides evidence and practical guidance for nurses to standardize the application of this thumb-tack needle technique in high-risk PONV patients. |
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