世界中医药

作者	单位
高寅秋1，时金华1，李辛洁2，董锡臣1，贾擎1，谢珅1，岳红1，关鑫1	1 中国中医科学院广安门医院麻醉科，北京，100053 2 开滦总医院麻醉科，唐山，063000

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中文摘要:

目的：观察电针治疗腰麻术后尿潴留患者的有效性。方法：选择2014年6月至2017年3月中国中医科学院广安门医院收治的100例腰麻下行下肢手术的患者，随机分为观察组和对照组各50例。观察组患者在腰麻术后，超声诊断测量膀胱内尿量，达到尿潴留标准后选取关元、中极、双侧归来穴行电针治疗，频率2/100 Hz，连续波，电流强度2 mA起，留针30 min,共治疗1次。对照组患者尿潴留后，单纯嘱患者按摩下腹、听流水声并积极排尿。比较2组的临床疗效。观察2组患者腰麻后30 min至膀胱内尿量达到尿潴留标准的时间、输液量、膀胱内尿量，第1次自主排尿时间、第1次排尿量、排尿后膀胱内残尿量、置入导尿管例数，及术后第1天排尿通畅情况、下腹坠胀、排尿不尽感发生率。结果：1)观察组患者膀胱内尿量达到尿潴留标准至术后第1次自主排尿时间较对照组早，差异有统计学意义(P<0.05)；2)第1次排尿量大于对照组，排尿后膀胱内残尿量小于对照组，差异有统计学意义(P<0.05)；3)观察组的导尿率为4.76%,显著低于对照组的导尿率19.05%,差异有统计学意义(P<0.05)。结论：电针可明显缩短腰麻后尿潴留患者的自主排尿时间，促进排尿，降低导尿率。疗效肯定，无不良反应。可临床推广应用。

English Summary:

To observe the electro-acupuncture effect on urinary retention after spinal anesthesia.Methods:A total of 100 cases who received lower limb surgery after spinal anesthesia in our hospital from June 2014 to March 2017 were chosen and randomly divided into observation group and control group，with 50 cases in each group.The patients in observation group were ultrasoundly measured the urine after spinal anesthesia surgery，and when the urine level reached urinary retention standard，they were received electro-acupuncture into Guanyuan (RN 4)，Zhongji (RN 3)，bilateral Guilai (ST 29) with a frequency of 2Hz/100 Hz，continuous wave，current of 2 mA for 30 minutes.For the control group，the patients were instructed to massage the bladder，pay attention to the floating of the urine in the bladder，and try to urinate，without any further treatment.The curative effects of both groups were compared.For both groups，time of urinary retention since 30 min after spinal anesthesia，transfusion volume，urine volume in urinary bladder，the time of the first automatic micturition since urinary retention，the volume of the first micturition，the residual volume after urine，the urethral catheterization cases，the urine condition of the first day after operation，the incidence rate of lower abdominal distention and/or incomplete urination were observed.Results:1) The time of automatic micturation from 30 min after spinal anesthesia to the urinary retention in the observation group was earlier than that in the control group with significant difference (P<0.05); 2) The volume of the first micturition was larger than that in the control group; the residual volume after urine was lower than that in the control group with significant difference (P<0.05); 3) Urethral catheterization rate in observation group was 4.76%，which was significantly lower than 19.05% in the control group with significant difference (P<0.05).Conclusion:Electro-acupuncture operation can effectively shorten patient's automatic micturition after spinal anesthesia，promote urination and reduce urethral catheterization rate，with certain curative effect and without adverse reactions，which is worthy of clinical application.

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