中国妇幼保健

目的 评估元胡止痛滴丸联合耳穴贴压法在经阴道植入网片盆底重建手术后镇痛及术后快速康复中的效果。方法 收集2022年1月—2023年4月在江西省妇幼保健院妇科住院的90例盆腔器官脱垂患者，均接受经阴道植入网片盆底重建手术，随机分为两组，每组45例。观察组术后应用元胡止痛滴丸联合耳穴贴压法镇痛，对照组采用传统术后镇痛泵止痛。应用疼痛视觉模拟评分(VAS)比较两组的镇痛效果，通过术后留置尿管时间、术后下床活动时间、排气时间、术后住院时间及并发症发生率等指标评估患者术后快速康复的效果。结果 观察组术后12、24、48 h VAS评分分别为(7.76±0.51)分、(5.93±0.42)分、(1.43±0.41)分；对照组术后12、24、48 h VAS评分分别为(7.53±0.82)分、(6.19±0.27)分、(4.73±0.81)分。观察组术后12 h VAS评分稍高于对照组，差异无统计学意义(P>0.05)。观察组术后24、48 h VAS评分均低于对照组，差异均有统计学意义(均P<0.05)。观察组手术时间、术中出血量及留置尿管时间分别为(68.90±4.50)min、(68.50±11.11)ml、(34.00±0.51)h,对照组手术时间、术中出血量及留置尿管时间分别为(70.60±5.30)min、(72.40±10.51)ml、(35.00±3.61)h,与对照组比较差异均无统计学意义(均P>0.05)。观察组术后下床活动时间、排气时间、术后住院时间分别为(12.80±0.44)h、(16.70±1.21)h、(3.80±1.31)d,对照组术后下床活动时间、排气时间、术后住院时间分别为(16.40±2.50)h、(20.20±5.81)h、(5.40±1.41)d,观察组均短于对照组，差异均有统计学意义(均P<0.05)。观察组并发症发生率为6.67%,低于对照组的31.11%,差异有统计学意义(P<0.05)。结论 元胡止痛滴丸联合耳穴贴压法可以有效缓解术后疼痛，降低术后并发症发生率，缩短术后住院时间，有助于患者术后快速康复。

Objective To evaluate the analgesic and rapid postoperative recovery effects of Yuanhu Zhitong Dropping Pills combined with ear acupoint pressing method after pelvic floor reconstruction surgery with mesh implantation. Methods Ninety patients with pelvic organ prolapse were selected from Department of Gynecology, Jiangxi Provincial Maternal and Child Health Care Hospital from January 2022 to April 2023, pelvic floor reconstruction surgery with mesh implantation was performed, and they were randomly divided into two groups, 45 cases in each group. The cases in observation group received postoperative pain relief using Yuanhu Zhitong Dropping Pills combined with ear acupoint pressing method, while the cases in control group received traditional postoperative pain relief pump. The pain visual analogue scale(VAS) was used to compare the analgesic effects of the two groups, the time of indwelling a catheter after surgery, and the time of getting out of bed after surgery, exhausting time, postoperative hospitalization time were used to evaluate the effect of rapid recovery effect of patients after surgery.Results VAS scores at 12, 24, and 48 hours after surgery in observation group were(7.76±0.51),(5.93±0.42), and(1.43±0.41), respectively; VAS scores at 12, 24, and 48 hours after surgery in control group were(7.53±0.82),(6.19±0.27), and(4.73±0.81), respectively. VAS score at 12 hours after surgery in observation group was slightly higher than that in control group, there was no statistically significant difference(P>0.05). VAS scores at 24 and 48 hours after surgery in observation group were statistically significantly lower than those in control group(P<0.05). The operation time, intraoperative bleeding volume, and indwelling catheter time in observation group were(68.90±4.50) minutes,(68.50±11.11) ml, and(34.00±0.51) hours, respectively; the operation time, intraoperative bleeding volume, and indwelling catheter time in control group were(70.60±5.30) minutes,(72.40±10.51) ml,(35.00±3.61) hours, respectively, there was no statistically significant difference(P>0.05). The time of getting out of bed after surgery, exhausting time, and postoperative hospital time in observation group were(12.80±0.44) hours,(16.70±1.21) hours, and(3.80±1.31) days, respectively; the time of getting out of bed after surgery, exhausting time, and postoperative hospital time in control group were(16.40±2.50) hours,(20.20±5.81) hours,(5.40±1.41) days, respectively, which were statistically significantly shorter than those in control group(P<0.05). The incidence rate of complications in observation group was 6.67%(3/45), which was lower than that in control group(31.11%), with a statistically significant difference(P<0.05).Conclusion The combination of Yuanhu Zhitong Dropping Pills and ear acupoint pressing method is effective in relieving postoperative pain, reducing postoperative complications, shortening postoperative hospitalization time, and helping patients recover quickly after surgery.