針刺治療術后惡心嘔吐一例并文獻復習_《華西醫學》

作者：

呂建琴 , 潘慧 ,  李寧

四川大學華西醫院中西醫結合科（成都，610041）;

關鍵詞：

針刺術后惡心嘔吐防治療效

DOI：

10.7507/1002-0179.20130543

視頻：

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　探討針刺治療在防治術后惡心嘔吐（PONV）中的作用與療效。方法　通過對2012年6月收治的1例全身麻醉下行小腦血腫清除術后出現持續性惡心嘔吐癥狀，后輔以針刺治療好轉的病例報道，就針刺治療對PONV的穴位選擇，刺激方式，介入時間等相關研究進行復習和總結。結果　患者惡心嘔吐癥狀在選取中脘、足三里（雙）、內關（雙）穴針刺治療3次后（30 min/次）明顯減少，自訴惡心程度較前緩解，連續針灸6次后嘔吐現象得到有效控制。結論　目前有關針刺治療PONV的研究越來越多，但尚無統一的治療標準。

引用本文： 呂建琴,潘慧,李寧. 針刺治療術后惡心嘔吐一例并文獻復習. 華西醫學, 2013, 28(11): 1726-1730. doi: 10.7507/1002-0179.20130543 復制

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1. 　Macario A, Weinger M, Carney S, et al. Which clinical anesthesia outcomes are important to avoid? The perspective of patients[J]. Anesth Analg, 1999, 89(3): 652-658.
2. 　Irefin SA, Schubert A, Bloomfield EL, et al. The effect of craniotomy location on postoperative pain and nausea[J]. J Anesth, 2003, 17(4): 227-231.
3. 　Latz B, Mordhorst C, Kerz T, et al. Postoperative nausea and vomiting in patients after craniotomy: incidence and risk factors[J]. J Neurosurg, 2011, 114(2): 491-496.
4. 　Gan TJ. Postoperative nausea and vomiting-can it be eliminated?[J]. JAMA, 2002, 287(10): 1233-1236.
5. 　Kovac AL. Prevention and treatment of postoperative nausea and vomiting[J]. Drugs, 2000, 59(2): 213-243.
6. 　Couture DJ, Maye JP, O’brien D, et al. Therapeutic modalities for the prophylactic management of postoperative nausea and vomiting[J]. J Perianesth Nurs, 2006, 21(6): 398-403.
7. 　White PF. Consensus guidelines for managing postoperative nausea and vomiting: is there a conflict of interest?[J]. Anesth Analg, 2004, 98(2): 550-551.
8. 　Habib AS, Gan TJ. Evidence-based management of postoperative nausea and vomiting:a review[J]. Can J Anaesth, 2004, 51(4): 326-341.
9. 　Nunley C, Wakim J, Guinn C. The effects of stimulation of acupressure point p6 on postoperative nausea and vomiting: a review of literature[J]. J Perianesth Nurs, 2008, 23(4): 247-261.
10. 　Kotani N, Hashimoto H, Sato Y, et al. Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses[J]. Anesthesiology, 2001, 95(2): 349-356.
11. 　Rusy LM, Hoffman GM, Weisman SJ. Electroacupuncture prophylaxis of postoperative nausea and vomiting following pediatric tonsillectomy with or without adenoidectomy[J]. Anesthesiology, 2002, 96(2): 300-305.
12. 　American Society of PeriAnesthesia Nurses PONV/PDNV Strategic Work Team. ASPAN’S evidence-based clinical practice guideline for the prevention and/or management of PONV/PDNV[J]. J Perianesth Nurs, 2006, 21(4): 230-250.
13. 　劉偉, 趙民, 祝力群, 等. 術后惡心嘔吐相關因素的臨床調查分析[J]. 中國醫師進修雜志, 2007, 30(3): 42-43.
14. 　吳會生, 劉丹彥. 術后惡心嘔吐(PONV)的風險因素及防治[J]. 醫學教育探索, 2008, 7(8): 888-891.
15. 　李寶貴, 陶富盛. 術后惡心嘔吐的中西醫認識和臨床對策[J]. 遼寧中醫藥大學學報, 2011(2): 135-138.
16. 　李學斌, 王會文, 張雪梅, 等. 顱腦手術麻醉后恢復室常見并發癥[J]. 中國康復理論與實踐, 2010, 16(5): 489-491.
17. 　宋先榮, 張咸虎, 程學敏. 術后惡心嘔吐相關因素的臨床調查[J]. 中華全科醫學, 2008, 6(7): 730-731.
18. 　Alkaissi A, Evertsson K, Johnsson VA, et al. P6 acupressure May relieve nausea and vomiting after gynecological surgery: an effectiveness study in 410 women[J]. Can J Anaesth, 2002, 49(10): 1034-1039.
19. 　Alkaissi AE, Stålnert M, Kalman S. Effect and placebo effect of acupressure(P6) on nausea and vomiting after outpatient gynaecological surgery[J]. Acta Anaesthesiol Scand, 1999, 43(3): 270-274.
20. 　Streitberger K, Diefenbacher M, Bauer A, et al. Acupuncture compared to placebo-acupuncture for postoperative nausea and vomiting prophylaxis: a randomised placebo-controlled patient and observer blind trial[J]. Anaesthesia, 2004, 59(2): 142-149.
21. 　徐韶怡, 鄭士立, 王慶來, 等. 耳穴針刺貼壓對婦科術后惡心嘔吐的抑制作用療效觀察[J]. 針刺研究, 2009, 34(2): 143-144.
22. 　劉焱紅, 于輝, 王博, 等. 經皮穴位電刺激對女性乳腺癌術后惡心嘔吐的影響[J]. 中國中醫藥科技, 2011, 18(1): 67-68.
23. 　裴英, 胡明, 王麗霞, 等. 針刺預防術后惡心嘔吐的臨床觀察[J]. 新疆中醫藥, 2010, 28(4): 36-37.
24. 　歐陽銘文, 秦再生, 林春水, 等. 針刺對腹腔鏡術后惡心、嘔吐的預防作用[J]. 中國針灸, 2009, 29(11): 915-918.
25. 　彭小蘭, 李政文, 呂黃勇, 等. 穴位敷蔥緩解內鏡下黏膜剝離術后惡心嘔吐的療效觀察[J]. 西南國防醫藥, 2011, 21(7): 754-755.
26. 　劉志順, 于金娜, 張瑞鋒, 等. 電針內關穴防治胃鏡檢查不良反應的療效和安全性評價[J]. 北京中醫, 2007, 26(1): 18-20.
27. 　Xu M, Zhou SJ, Jiang CC, et al. The effects of P6 electrical acustimulation on postoperative nausea and vomiting in patients after infratentorial craniotomy[J]. J Neurosurg Anesthesiol, 2012, 24(4): 312-316.
28. 　Wang SM, Kain ZN. P6 acupoint injections are as effective as droperidol in controlling early postoperative nausea and vomiting in children[J]. Anesthesiology, 2002, 97(2): 359-366.
29. 　Butkovic D, Toljan S, Matolic M, et al. Comparison of laser acupuncture and metoclopramide in PONV prevention in children[J]. Paediatr Anaesth, 2005, 15(1): 37-40.
30. 　姜玲. 穴位按壓緩解甲狀腺術后惡心嘔吐66例效果觀察[J]. 齊魯護理雜志, 2012, 18(5): 3.
31. 　唐敏芳, 嚴閃紅. 穴位按壓對甲狀腺術后嘔吐的防治效果觀察[J]. 中外健康文摘, 2011, 8(22): 438-438.
32. 　許占宏, 董全玲, 王國年, 等. 韓氏穴位神經刺激儀對甲狀腺術后的影響[J]. 哈爾濱醫科大學學報, 2005, 39(4): 364-366.
33. 　商軍科, 楊志光, 薛麗. 針刺對62例硬膜外阻滯下行腹部手術后胃腸功能恢復的影響[J]. 陜西中醫, 2001, 22(7): 416.
34. 　戈宏焱, 陳博, 李有田. 針刺對腎移植術后患者胃腸道反應的影響[J]. 中國針灸, 2008, 28(3): 177-178.
35. 　馮璐, 王君. 針藥結合治療術后惡心嘔吐療效觀察[J]. 天津中醫藥, 2008, 25(2): 108-110.
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