颊针疗法联合星状神经节阻滞改善老年结肠癌术后睡眠质量的临床研究

Buccal acupuncture combined with stellate ganglion block for sleep improvement after colorectal cancer surgery in the elderly: a clinical study

摘要:

背景与目的 老年结肠癌患者在接受腹腔镜根治术后常伴有睡眠质量下降，而良好的睡眠有助于术后快速康复。目前，临床上多采用药物干预改善术后睡眠问题，但常规药物治疗可能引发谵妄及成瘾等不良反应。为探索更安全有效的非药物干预手段，本研究评估颊针疗法联合超声引导下星状神经节阻滞（SGB）对术后睡眠质量的影响。方法 纳入2024年2月—8月在长沙市第四医院接受腹腔镜结肠癌根治术的60例老年患者，采用随机数字表法分为试验组和对照组，各30例。对照组采用SGB干预，试验组在此基础上联合应用颊针疗法。记录围手术期平均动脉压（MAP）、心率（HR）、术后视觉模拟评分（VAS）、匹兹堡睡眠质量指数（PSQI）及不良反应发生率。结果 两组患者的一般资料差异无统计学意义（均P>0.05）。试验组术中及术后HR、MAP明显低于对照组（均P<0.05）；术后6、24、48 h的VAS评分及术后第1、3、5天的PSQI评分均低于对照组（均P<0.05），且嗜睡发生率明显减少（P<0.05）。两组恶心呕吐和躁动发生率差异无统计学意义（均P>0.05）。结论 颊针疗法联合SGB在老年结肠癌患者围手术期的应用，不仅能显著改善术后睡眠质量，减轻术后疼痛，还可降低不良反应发生率，是一种安全、有效的非药物干预手段，值得在临床推广应用。

Abstract:

Background and Aims Elderly patients undergoing laparoscopic radical resection of colon cancer often experience decreased sleep quality, which may hinder postoperative recovery. Although pharmacological interventions are commonly used in clinical practice to improve postoperative sleep, conventional medications may lead to adverse effects such as delirium and dependence. This study aimed to evaluate the effect of a non-pharmacological intervention—buccal acupuncture combined with ultrasound-guided stellate ganglion block (SGB)—on postoperative sleep quality in elderly patients.Methods A total of 60 elderly patients who underwent laparoscopic radical resection of colon cancer at the Forth Hospital of Changsha from February to August 2024 were enrolled. Using a random number table, the patients were divided into two groups: 30 in the control group (SGB alone) and 30 in the study group (SGB combined with buccal acupuncture). Perioperative mean arterial pressure (MAP), heart rate (HR), postoperative visual analogue scale (VAS) scores, Pittsburgh Sleep Quality Index (PSQI) scores, and the incidence of adverse events were recorded and analyzed.Results There were no statistically significant differences in baseline characteristics between the two groups (all P>0.05). The study group showed significantly lower intraoperative and postoperative HR and MAP compared to the control group (all P<0.05). VAS scores at 6, 24, and 48 h postoperatively, as well as PSQI scores on postoperative days 1, 3, and 5, were significantly lower in the study group (all P<0.05). Additionally, the incidence of drowsiness was significantly reduced (P<0.05). No significant differences were found between the two groups in terms of nausea, vomiting, or agitation (all P>0.05).Conclusion The combination of buccal acupuncture and SGB during the perioperative period can effectively improve postoperative sleep quality, alleviate pain, and reduce adverse reactions in elderly patients undergoing laparoscopic radical resection of colon cancer. This safe and effective non-pharmacological intervention holds promising clinical application value.