目的 分析腕踝针结合耳穴压豆对肛瘘患者术后疼痛及尿潴留的改善效果.方法 选取 2021 年 9 月至2022 年9 月上海市徐汇区大华医院收治的126 例拟行手术治疗的肛瘘患者为研究对象,按照简单随机法分为观察组(63 例)与对照组(63 例).2 组均给予常规综合护理及耳穴压豆,观察组加用腕踝针干预.对比2 组患者在换药时、排便时的疼痛程度,并比较2 组的首次排尿时间和首次排尿量,以及术后尿潴留、尿路刺激征等的发生率.结果 2 组在术后2d和3d换药时、排便时的视觉模拟评分法(VAS)评分均较术后1d下降(P均<0.05);观察组在术后1d、2d和3d换药时、排便时的VAS评分均低于同期对照组,差异均有统计学意义(P均<0.05).观察组的术后首次排尿时间早于对照组,首次排尿量大于对照组,差异均有统计学意义(P均<0.05).观察组术后尿潴留、尿路刺激征和术后2h尿潴留相关腹胀的发生率均低于对照组(P均<0.05).结论 在常规综合护理及耳穴压豆的基础上,将腕踝针应用于肛瘘患者的术后干预中,对于减轻患者在换药时和排便时的疼痛程度,促进其尽早排尿,以及降低术后尿潴留、尿路刺激征和尿潴留相关腹胀的发生率均有积极作用.
Objective To analyze the effect of wrist-ankle acupuncture combined with auricular bean-pressing therapy on postoperative pain and urinary retention in patients with anal fistula.Methods A total of 126 patients with anal fistula who were to undergo surgical treatment at Dahua Hospital,Xuhui District,Shanghai from September 2021 to September 2022 were selected as the study subjects.They were divided into an observation group(63 cases)and a control group(63 cases)according to the simple random method.The two groups were given routine comprehensive nursing and auricular bean-pressing therapy,while the observation group was additionally treated with wrist-ankle acupuncture.The pain degree during dressing change and defecation was compared between the two groups,and the first urination time and volume,as well as the incidence of postoperative urinary retention and urinary irritation symptoms were compared between the two groups.Results The Visual Analogue Scale(VAS)scores during dressing change and defecation in both groups on the 2nd and 3rd day after surgery decreased compared to on the 1st day after surgery(all P<0.05).The VAS scores during dressing change and defecation in the observation group on the 1st,2nd,and 3rd day after surgery were lower than those in the control group during the same period,with statistically significant differences(all P<0.05).The first postoperative urination time of the observation group was earlier than that of the control group,and the first postoperative urination volume was greater than that of the control group,with statistically significant differences(all P<0.05).The incidence of postoperative urinary retention,urinary irritation symptoms and postoperative 2h urinary retention related abdominal distension in the observation group was lower than that in the control group(all P<0.05).Conclusion On the basis of routine comprehensive nursing and auricular bean-pressing therapy,wrist-ankle acupuncture is applied to postoperative intervention of patients with anal fistula,which has a positive effect on alleviating the pain of patients during dressing change and defecation,promoting early urination and reducing the incidence of postoperative urinary retention,urinary irritation symptoms and urinary retention related abdominal distension.