探讨术前静脉应用地佐辛联合术后给予耳穴压豆对老年患者无痛胃镜下黏膜切除术后疼痛的缓解效果。

选取2020年1月至2021年2月在浙江医院接受无痛胃镜下黏膜切除术的老年患者300例并随机（抽签法）分组，其中100例术前应用地佐辛联合术后耳穴压豆（地佐辛+耳穴压豆组），100例仅术前应用地佐辛（地佐辛组），100例无上述干预措施（对照组）。排除胃镜检查时发现合并消化性溃疡、手术中发现新病灶及术后出现迟发性穿孔的30例患者，最终地佐辛+耳穴压豆组88例、地佐辛组93例、对照组89例。采用视觉模拟评分法（VAS）对患者术后3、12、24、48 h的腹痛程度进行评分，统计术后不良反应等情况。计数资料的比较采用χ²检验，计量资料的比较采用方差分析，腹痛程度的比较采用混合效应模型。

地佐辛+耳穴压豆组、地佐辛组术后腹痛发生率的差异无统计学意义（χ²=0.221，P>0.05），但均明显低于对照组（χ²=8.037、5.924，P<0.05或0.01）。3组患者腹痛程度的差异呈现出组别、时间差异（F=7.718、29.690，P<0.01）；地佐辛+耳穴压豆组和地佐辛组的腹痛程度均较对照组轻（P<0.01），患者术后12、24 h腹痛程度均高于术后3、48 h（P<0.01）。3组患者术后不良反应发生率的差异无统计学意义（χ²=4.260，P>0.05）。

地佐辛联合术后及时给予耳穴压豆对缓解老年患者胃镜下黏膜切除术后疼痛有较好的效果，无明显不良反应，值得临床推广。

To evaluate the effectiveness of dezocine combined with auricular point sticking to relieve the postoperation pain of painless gastric endoscopic mucosal resection in elderly patients.

A total of 300 elderly patients who underwent painless endoscopic mucosal resection in Zhejiang Hospital during January 2020 and February 2021 were randomly divided into three groups. Among them, 100 cases were treated with dizocine before operation combined with auricular point sticking after operation (dizocine + auricular point sticking group), 100 cases were treated with dizocine only (dizocine group), and 100 cases were not treated with the above intervention measures (control group). Excluding 30 cases with peptic ulcer found during gastroscopy, new focus found during operation and delayed perforation after operation, there were 88 cases in the dizocine + auricular point sticking group, 93 cases in the dizocine group and 89 cases in the control group. Visual analogue scale (VAS) was used to score the degree of abdominal pain at 3, 12, 24 and 48 hours after operation, and the postoperative adverse reactions were recorded. Chi-square test was used for comparison of counting data, analysis of variance was used for comparison of measurement data, and mixed effect model was used to compare the degree of abdominal pain.

The incidence of postoperative abdominal pain in the dizocine + auricular point sticking group and dizocine group was significantly lower than that in the control group (χ²=8.037, 5.924, P < 0.05 or 0.01), but there was no significant difference between the two groups (χ²=0.221, P > 0.05). The degree of abdominal pain was differed among groups and among different time points (F=7.718, 29.690, P < 0.01), which was lighter in dizocine + auricular point sticking group and dizocine group compared with the control group (P < 0.01), and that at 12 and 24 hours after operation was higher than that at 3 and 48 hours after operation (P < 0.01). There was no significant difference in the incidence of postoperative adverse reactions among the three groups (χ²=4.260, P > 0.05) .

Dizocine combined with auricular point sticking has a good effect on relieving the pain of elderly patients after endoscopic mucosal resection without obvious adverse reactions, which is worthy of clinical application.