经皮穴位电刺激对手术患者胃排空的影响  

Effect of transcutaneous electrical acupoint stimulation on gastric emptying in patients undergoing surgery

作　　者：莫云长[1] 张安琪[1] 郑波 陈成宇[1] 任冶龙 王茜茜 傅海峰 林领敏 王均炉[1] 

机构地区：[1]温州医科大学附属第一医院麻醉科,浙江温州325000 [2]温州医科大学附属台州医院手术部 [3]温州市龙湾区人民医院

出　　处：《中国针灸》2017年第12期1261-1264,共4页Chinese Acupuncture & Moxibustion

基　　金：国家科技部973计划课题:2013 CB 531903;国家自然科学基金项目:81603685;81573742;浙江省中医药科技计划项目:2017 ZA 133;温州市科技局项目:Y 20150229;Y 20140349

摘　　要：目的:基于超声评估胃排空速度来观察经皮穴位电刺激(TEAS)对手术患者胃排空的影响。方法:选择需行蛛网膜下腔阻滞的下肢手术患者75例,均为下午择期手术患者,根据随机数字表法随机分为经皮穴位电刺激组(TEAS组)、假经皮穴位电刺激组(Sham组)和对照组,每组25例。每组患者均在手术当日8点给予半流质试验餐。TEAS组进食后5 min开始于双侧足三里与内关穴行电刺激,刺激频率为5 Hz,刺激时间为30 min,强度为患者能忍受阈值减1 m A;Sham组在相同的穴位给予感觉阈减1 m A的电流强度;对照组不给予任何干预。分别在空腹时(T0)、进食即刻(T1)、进食后每隔半小时(T2~T6)进行超声测量,分别测定半卧位与右侧卧位胃内容物及胃排空时间。结果:在进食后,3组患者在T3、T4、T5、T6时间点胃内容物明显少于T1时的胃内容物(均P<0.05);在T4、T5、T6时间点,TAES组半卧位胃内容物明显少于对照组及Sham组(均P<0.05);在T5、T6时间点,TEAS组右侧卧位胃内容物明显少于对照组及Sham组(均P<0.05)。TEAS组胃排空时间明显短于Sham组及对照组(均P<0.05)。结论:通过胃部超声可以评估胃排空速度,REAS可以提高手术患者进食后的胃排空速度,缩短胃排空时间。Objective To observe the effects of transcutaneous electrical acupoint stimulation （TEAS） on gastric emptying in patients undergoing selective surgery based on velocity of gastric emptying by ultrasonography. Methods A total of 75 patients with selective operation of subarachnoid block at lower limb in the afternoon were randomly assigned to a TEAS group, a sham group and a control group, 25 patients in each one. All the patients were provided with semi-fluid diet at 8 a.m. The TEAS group was treated with TEAS 5 min after semi-fluid diets at bilateral Zusanli （ST 36） and Neiguan （PC 6） for 30 min, with frequency of 5 Hz and intensity which was 1 mA lower than the tolerance threshold. The sham group patients were stimulated at the same acupoints with current intensity which was 1 mA lower than the sensory threshold. The control group received no treatment. On the day of operation, and ultrasonography was given at time of empty stomach （TO）, immediately after the semi-fluid diets （T1）, and every 30 min after diets （T2-T6）, respectively, to measure the gastric content and emptying time at semire-clining position and right lateral position. Results The volume of gastric content in the three groups at T3-T6 was significantly less than that at T1 （all P〈 0.05）. The volume of gastric content at T4--T6 at semire-clining position in the TEAS group was significantly less than that in the control group and sham group （all P〈 0.05）. The volume of gastric content at TS-T6 at right lateral position in the TEAS group was significantly less than that in the control group and sham group （all P〈 0.05）. The gastric emptying time in the TEAS group was significantly less than that in the control group and sham group （both P〈 0.05）. Conclusion The gastric emptying velocity could be evaluated by ultrasonography, TEAS could improve the velocity of gastric emptying and reduce the gastric emptying time.

关 键 词：经皮穴位电刺激 穴 足三里 穴 内关 超声 围术期 胃排空 加速康复外科 

分 类 号：R246.2[医药卫生—针灸推拿学]