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[经皮穴位电刺激对水囊法扩张前额部皮肤软组织扩张器患者疼痛的影响]

[Effects of transcutaneous electrical acupoint stimulation on pain of patients in expansion process of skin soft tissue dilator on forehead by water injection].

作者信息

Huang Y, Bian W W, Hou L L

机构信息

Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.

Nursing Department, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2019 Mar 20;35(3):193-197. doi: 10.3760/cma.j.issn.1009-2587.2019.03.006.

DOI:10.3760/cma.j.issn.1009-2587.2019.03.006
PMID:30897865
Abstract

To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) on pain of patients in expansion process of skin soft tissue dilator on forehead by water injection. From June 2016 to June 2017, 100 patients in expansion process of skin soft tissue dilator on forehead by water injection meeting the inclusion criteria were admitted to Outpatient Department of Orthopedic Surgery of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. There were 43 men and 57 women among the patients, aged 27 to 55 years, and the prospective randomized controlled study was performed on them. The patients were divided into TEAS nursing group and routine nursing group according to the random number table, with 50 patients in each group. Patients in routine nursing group were performed with routine nursing in every water injection in outpatient department and 2 days later. On the basis of routine nursing, patients in TEAS nursing group were performed with TEAS treatment by responsible nurses in each water injection in outpatient department. The Shangxing, Diwei, and Hegu points were positioned accurately, and electrical stimulation was performed on the 3 points simultaneously by pulse acupuncture treatment instrument, with 30 minutes each time. Two days after every water injection of outpatient department, TEAS nursing was performed at home by patients and their family members under remote guidance of the responsible nurses, with 2 times each day and 30 minutes each time. Besides, follow-up was done by phone by the responsible nurses everyday. The nursing of patients in the 2 groups lasted the whole expansion process. After the expansion process, the overall pain degree and the most severe pain degree of patients during expansion process were scored by numerical rating scale, and the overall comfort degree and its dimensions of patients during expansion process were scored by the responsible nurses every day by simplified Comfort Status Scale. Data were processed with independent sample test and chi-square test. During expansion process, the overall pain score degree and the most severe pain degree score of patients in TEAS nursing group were (5.4±1.2) and (6.5±1.0) points, which were significantly lower than (6.1±1.3) and (7.5±1.4) points of patients in routine nursing group (=-2.62, -4.00, <0.05 or <0.01). During expansion process, the physiological dimension, sociocultural dimension, psychological spirit dimension, environmental dimension, and total score of the overall comfort degree of patients in TEAS nursing group were (9.6±2.9), (20.1±2.8), (29.1±1.9), (22±3), and (80±6) points, significantly higher than (5.7±2.1), (16.8±2.8), (26.0±2.8), (21±4), and (69±8) points of patients in routine nursing group (=8.03, 6.35, 7.60, 2.11, 10.64, <0.05 or <0.01). TEAS with appropriate intensity, frequency, and duration can alleviate the pain of patients during expansion process of skin soft tissue dilator on forehead by water injection and improve their comfort degree.

摘要

探讨经皮穴位电刺激(TEAS)对水囊法扩张前额部皮肤软组织扩张器患者疼痛的影响。选取2016年6月至2017年6月在上海交通大学医学院附属第九人民医院整复外科门诊就诊、符合纳入标准的水囊法扩张前额部皮肤软组织扩张器患者100例,其中男43例,女57例,年龄27~55岁,进行前瞻性随机对照研究。根据随机数字表法将患者分为TEAS护理组和常规护理组,每组50例。常规护理组患者在门诊每次注水及注水后2 d进行常规护理。TEAS护理组患者在常规护理的基础上,门诊每次注水时由责任护士进行TEAS治疗。准确选取上星、地维、合谷穴,采用脉冲电针治疗仪同时对3个穴位进行电刺激,每次30 min。门诊每次注水后2 d,患者及家属在责任护士远程指导下在家中进行TEAS护理,每天2次,每次30 min。此外,责任护士每天电话随访。两组患者的护理均持续至整个扩张过程结束。扩张结束后,采用数字评分法对患者扩张过程中的总体疼痛程度和最严重疼痛程度进行评分,责任护士每天采用简化舒适状况量表对患者扩张过程中的总体舒适度及其维度进行评分。数据采用独立样本t检验和χ²检验进行处理。扩张过程中,TEAS护理组患者的总体疼痛评分程度和最严重疼痛评分程度分别为(5.4±1.2)分和(6.5±1.0)分,明显低于常规护理组患者的(6.1±1.3)分和(7.5±1.4)分(t=-2.62,-4.00,P<0.05或<0.01)。扩张过程中,TEAS护理组患者总体舒适度的生理维度、社会文化维度、心理精神维度及环境维度评分和总分分别为(9.6±2.9)分、(20.1±2.8)分、(29.1±1.9)分、(22±3)分和(80±6)分,明显高于常规护理组患者的(5.7±2.1)分、(16.8±2.8)分、(26.0±2.8)分、(21±4)分和(69±8)分(t=8.03,6.35,7.60,2.11,10.64,P<0.05或<0.01)。适当强度频率和持续时间的TEAS可减轻水囊法扩张前额部皮肤软组织扩张器患者扩张过程中的疼痛,提高其舒适度。

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