目的:本研究的目的是评估耳穴贴压对肛周脓肿患者术后疼痛和焦虑的缓解效果。
方法:纳入南通市第一人民医院于2019年7月至2020年6月收治的61例肛周脓肿患者,计划接受一期根治术。我们将它们分为治疗组(n=31),患者术前耳穴贴压针对双侧神门,皮质下,和其他点。他们被指示每天施加压力五到六次,每次约3-5分钟。对照组(n=30)接受常规术前准备。两组治疗时间均为1周。比较两组采用疼痛视觉模拟量表(VAS)评分,使用额外的术后镇痛药,以及手术前和手术后6小时汉密尔顿焦虑和抑郁量表的得分,24h,48h,72小时,手术后1周,以及在第一次排便时。
结果:治疗组48h时VAS评分低于对照组,72小时,1周,在手术后第一次排便时,差异均有统计学意义(均P<0.05)。治疗组7例(22.58%)和对照组10例(33.33%)增加了术后镇痛药。两组间差异无统计学意义(χ2=0.88,P=0.35)。治疗组术后汉密尔顿焦虑量表(HAM-A)和汉密尔顿抑郁量表(HAM-D)评分均显著低于对照组(P<0.05)。
结论:本研究结果表明,耳穴贴压可有效缓解肛周脓肿患者术后疼痛,同时减轻其术后心理应激反应。这种双重作用既缓解疼痛又减少焦虑,不良反应少。使其成为安全有效的治疗选择。
OBJECTIVE: The objective of this study is to assess the efficacy of auricular point acupressure in relieving postoperative pain and reducing anxiety among patients with perianal abscesses.
METHODS: We included 61 patients with perianal abscesses who were admitted to the Nantong First People\'s Hospital between July 2019 and June 2020 and were scheduled to undergo one-stage radical surgery. We divided them into the treatment group (n = 31), where patients were administered preoperative auricular acupressure targeting the bilateral Shenmen, subcortical, and other points. They were instructed to apply pressure five to six times per day, each time for about 3-5 min. Patients in the control group (n = 30) received routine preoperative preparation. The treatment duration for both groups was one week. We compared the two groups using the pain visual analog scale (VAS) scores, the use of additional postoperative analgesics, and scores on the Hamilton anxiety and depression scales pre- and post-surgery at 6 h, 24 h, 48 h, 72 h, and 1 week after surgery, as well as at the time of the first bowel movement.
RESULTS: Patients in the treatment group reported lower VAS scores than those of the control group at 48 h, 72 h, 1 week, and at the first defecation post-surgery, and the differences were statistically significant (all P < 0.05). Additional postoperative analgesics were used in seven patients in the treatment group (22.58 %) and in 10 patients in the control group (33.33 %). The difference between the two groups was not statistically significant (χ2 = 0.88, P = 0.35). Postoperative scores for the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Depression Rating Scale (HAM-D) in the treatment group were significantly lower than those in the control group (P < 0.05).
CONCLUSIONS: The results of this study demonstrated that auricular point acupressure was effective in alleviating postoperative pain in patients with perianal abscesses and simultaneously reduced their postoperative psychological stress reactions. This dual effect provided both pain relief and a reduction of anxiety with fewer adverse reactions, making it a safe and effective treatment option.