经皮穴位电刺激对结直肠肿瘤患者术后肠功能的影响  

Effect of transcutaneous electrical stimulation on postoperative intestinal function in patients with colorectal cancer

作　　者：张海亮[1] 郝静静[2] 白延斌[1] 路喻清[1] Zhang Hailiang;Hao Jingjing;Bai Yanbin;Lu Yuqing(Department of Anesthesia,Yan'an University Affiliated Hospital,Shaanxi Yan'an 716000,China;Neonatal Pediatrics,Yan'an University Affiliated Hospital,Shaanxi Yan'an 716000,China)

机构地区：[1]延安大学附属医院麻醉科,陕西延安716000 [2]延安大学附属医院新生儿科,陕西延安716000

出　　处：《现代肿瘤医学》2020年第4期611-614,共4页Journal of Modern Oncology

基　　金：陕西省自然科学基础研究一般项目(面上)(编号:2018JM7067)

摘　　要：目的:观察经皮穴位电刺激(transcutaneous electrical stimulation,TEAS)对结直肠术后患者胃肠功能恢复的影响。方法:选择择期行结直肠癌手术的患者90例(男59例,女31例),年龄≥18岁,ASA分级Ⅰ-Ⅲ级,将其随机分为TEAS组和对照组各45例。TEAS组:于手术结束拔管后患者配合情况下及术后3天内同一时间段行双侧足三里、上巨虚、三阴交穴位TEAS一次,每次30 min,选择2 Hz疏密波,强度为患者能够耐受的最大强度,一般为10~25 mA;对照组操作同TEAS组,但不开启电源。所有患者采用静吸复合全身麻醉,术前超声引导行腹横肌平面(TAP)阻滞,术中使用脑电(BIS)、体温、有创血压监测并采用肺保护通气策略,术后使用静脉自控镇痛。观察并记录两组患者一般情况(性别、年龄、体重、手术时间、术中出血量、补液量、尿量);记录两组患者术后肠蠕动恢复、肛门首次排气、进饮/食时间及术后3天内腹胀、恶心呕吐发生率;记录两组患者术前、术后12、24、48、72 h血清胃动素浓度。结果:两组患者一般情况无统计学差异;TEAS组患者术后肠蠕动恢复时间、肛门首次排气时间及进饮时间明显短于对照组(P<0.05),术后3天内腹胀、恶心呕吐发生率较对照组明显降低(P<0.05)。结论:TEAS可促进术后结直肠癌患者肠功能的早期恢复,并且可以减少术后并发症的发生率。To observe the effect of transcutaneous electrical stimulation on the recovery of gastrointestinal function in patients after colorectal surgery.Methods:90 patients(59 males and 31 females)undergoing elective operation for colorectal cancer were selected.The age was≥18 years old.ASA grade wasⅠ-Ⅲ.The patients were randomly divided into TEAS group and control group.TEAS group:Bilateral Zusanli was performed at the same time after extubation of hand and within 3 days after operation,and TEAS was performed once at the point of Sanyinjiao,30 minutes each time.The dense wave of 2 Hz was selected at the same time period after extubation of hand and within 3 days after operation.The maximum strength of the patient was 10~25 mA.The control group was operated the same as the TEAS group,but the power supply was not turned on.All the patients were subjected to intravenous anesthesia combined with general anesthesia,preoperative ultrasound-guided(TAP)block of the transverse abdominal muscle,electroencephalogram(BIS),body temperature,invasive blood pressure monitoring and pulmonary protection ventilation strategy,and postoperative patient-controlled intravenous analgesia(PCEA).The general condition of each group was observed and recorded(gender,age,weight,operation time,intraoperative bleeding,volume of fluid rehydration,urine volume).The recovery of intestinal peristalsis,the first anal exsufflation,drinking,feeding time,abdominal distension,nausea and vomiting within 3 days after operation were recorded in the two groups,and the serum motilin concentrations were recorded before operation,12,24,48,72 hours after operation in the two groups.Results:There was no statistical difference between the two groups in general.The recovery time of intestinal peristalsis,the first exhaust time and drinking time of anus in TEAS group were significantly shorter than those in control group(P<0.05).The incidence of abdominal distension,nausea and vomiting within 3 days after operation was significantly lower than that in control group(

关 键 词：结直肠手术 经皮穴位电刺激 肠功能恢复 

分 类 号：R735.3[医药卫生—肿瘤]