经皮穴位电刺激对腹腔镜肠道手术围术期胃肠道功能的影响  

Effect of transcutaneous electrical acupoint stimulation on gastrointestinal function in perioperative period of laparoscopic intestinal surgery

作　　者：袁岚[1] 郭君[1] 唐炜[1] 王剑[1] 傅国强[1] 郭丰[1] 

机构地区：[1]上海中医药大学附属曙光医院麻醉科,201203

出　　处：《临床麻醉学杂志》2017年第6期567-569,共3页Journal of Clinical Anesthesiology

基　　金：上海市卫生和计划生育委员会中医药科研基金资助(2014LP091B);国家重点基础研究发展计划(973-2013CB531901);上海市中医药事业发展三年行动计划项目(ZY3-CCCX-2-1003)

摘　　要：目的观察经皮穴位电刺激(transcutaneous electrical acupoint stimulation,TEAS)对腹腔镜肠道手术后胃肠道功能恢复的影响。方法选择择期行腹腔镜下肠切除手术患者60例,男28例,女32例,年龄18~65岁,ASAⅠ或Ⅱ级,随机分为TEAS组和对照组。TEAS组在手术当天及术后3d内每天给予内关、合谷、足三里等穴位TEAS一次,对照组操作同TEAS组但不开启电源。记录两组患者术前、术后12、24、48、72h血清胃动素浓度;术后肠蠕动恢复时间、肛门排气时间、住院时间以及术后3d内恶心呕吐的发生率。结果与对照组比较,TEAS组术后24h血清胃动素浓度明显升高[(218.5±52.3)pg/ml vs(141.8±45.8)pg/ml,P<0.05],术后肠鸣音恢复时间[(19.4±3.2)h vs(29.6±7.8)h,P<0.05]明显提前,肛门首次排气时间明显提前[(23.2±4.7)h vs(36.5±8.9)h,P<0.05],术后3d内恶心呕吐发生率明显降低(16.7%vs 36.7%,P<0.05)。两组住院时间差异无统计学意义。结论经皮穴位电刺激可促进腹腔镜肠道手术围术期胃肠道功能的恢复。Objective To observe the effect of transcutaneous electrical acupoint stimulation（TEAS）on the recovery of gastrointestinal function after laparoscopic intestinal operation.Methods Sixty patients of the selective laparoscopic intestinal resection,28 males and 32 females,aged 18-65 years,ASA physical status Ⅰ or Ⅱ,were enrolled and randomly allocated into two groups：TEAS group and control group,30 in each group.Patients in TEAS group accepted transcutaneous electrical acupoint stimulation treatment at Neiguan,Hegu,Zusanli points from the time before induction of anesthesia to 3days after surgery,and patients in the control group were treated with transcutaneous electrical acupoint stimulation,but the electrode pads were just attached on the related points with no electric stimulation.Plasma motilin concentrations preoperatively,postoperatively 12,24,48 and 72hwere measured in the two groups.The recovery time of intestinal peristalsis,anal flatus time,in-hospital time and the incidence of nausea and vomiting within 3days after operation were observed.Results Compared with the control group,serum motilin concentration postoperative 24 hincreased significantly[（218.5±52.3）pg/ml vs（141.8±45.8）pg/ml,P〈0.05],the time of intestinal peristalsis recovery [（19.4±3.2）h vs（29.6±7.8）h,P〈0.05]and flatus[（23.2±4.7）h vs（36.5±8.9）h,P〈0.05]were shorter,the incidence of postoperative nausea and vomiting within 3days after operation decreased significantly in TEAS group（16.7% vs 36.7%,P〈0.05）.There was no statistically significant difference of the in-hospital time between the two groups.Conclusion TEAS can promote the recovery of gastrointestinal function in patients undergoing laparoscopic intestinal surgery.

关 键 词：经皮穴位电刺激 腹腔镜 肠道手术 

分 类 号：R614[医药卫生—麻醉学]