经皮穴位电刺激辅助全身麻醉可减轻妇科腹腔镜手术的术后反应  

Effect of Transcutaneous Electrical Stimulation of Zusanli(ST 36)and Liangqiu(ST 34)Combined with General Anesthesia on Pain and Gastrointestinal Symptoms in Patients Undergoing Gynecological Laparoscopic Operation

作　　者：殷岫绮[1] 周一辰[1] 周华[1] 杨红[1] 王永强[2] 张翮[3] 

机构地区：[1]上海中医药大学附属曙光医院妇科,上海201203 [2]上海中医药大学附属曙光医院麻醉科,上海201203 [3]上海中医药大学附属龙华医院针灸科,上海200032

出　　处：《针刺研究》2013年第6期431-434,共4页Acupuncture Research

基　　金：上海市中医药事业发展三年行动计划(重大研究)项目"针药复合麻醉优选方案及临床疗效评价研究"资助(ZYSNXD-CC-ZDY J 014);上海市中医药事业发展三年行动计划(重大研究)项目"研究型中医院建设"资助(ZYSNXD-CC-YJXYY-JS 19)

摘　　要：目的:观察经皮穴位电刺激联合全身麻醉是否能改善妇科腹腔镜术后患者的疼痛及胃肠道症状。方法:将60例择期行妇科腹腔镜手术的患者随机分为对照组和观察组,每组30例。对照组行全身麻醉;观察组行经皮穴位电刺激结合全身麻醉,取双侧足三里、梁丘穴,连接韩氏穴位神经刺激仪,2Hz连续波,电流强度由弱至强,逐渐达到患者能耐受的最大量(不超过2mA),刺激持续30min后进行全身麻醉,直至手术结束。观察患者术后8、24、72h的视觉模拟评分(VAS)值,恶心、呕吐评级,术后排气、排便时间。结果:①观察组术后VAS值在各时间点均较对照组降低(P<0.01);②观察组术后恶心程度较对照组减轻(P<0.05),呕吐程度较对照组也有一定程度的减轻,但差异无统计学意义(P>0.05);③观察组术后排气、排便时间均较对照组提前(P<0.01)。结论:经皮穴位电刺激联合全身麻醉可以缓解患者术后疼痛,减少恶心、呕吐次数及程度,加快肠功能的恢复。Objective To observe the effects of transcutaneous acupoint electrical stimulation （TAES） combined with general anesthesia （acupuncture analgesia combined with general anesthesia） on postoperative pain, nausea and vomiting and ex- hausted defecation symptoms in patients undergoing gynecological laparoscopic operation. Methods Sixty patients with gyne- cological laparoscopic operation were randomly divided into TAES group and control group, with 30 cases in each group. Patients of the control group received simple general anesthesia and those of the TAES group were treated with general anesthesia and TAES of bilateral Zusanli （ST 36） and Liangqiu （ST 34） . Visual Analogue Scale （VAS） was used for measuring the patients＇ pain reaction at 8 h, 24 h and 72 h after surgery. Symptoms of patients＊ nausea and vomiting, post-operation exhaust and defecation time were recorded after operation. Results The VAS scores at time-points of 8 h, 24 h and 72 h and nausea level in the TAES group were significantly lower than those of the control group （P〈0.01, P〈0.05）. The vomiting severity of the TAES group was also relatively lower in comparison with the control group, but without significant difference between the two groups （P〉0.05）. The post-operation exhaust and defecation time of patients in the TAES group apparently appeared earlier than those of patients in the control group （〈O. 01）. Conclusion TAES combined with general anesthesia is effective in reducing post-operative pain and nausea, and improving gastrointestinal function in patients undergoing laparoscopic operation.

关 键 词：经皮穴位电刺激 妇科 腹腔镜手术 针刺复合麻醉 

分 类 号：R245.97[医药卫生—针灸推拿学]