经皮穴位电刺激辅助麻醉在腔镜肠癌根治术患者加速康复外科中的应用  

Application of Transcutaneous Electrical Point Stimulation Combined with Anesthesia to Patients After Laparoscopic Radical Resection for Colorectal Cancer in Enhanced Recovery after Surgery

作　　者：蔡清香[1] 赵敏 黎玉辉[1] 黄彦逵 黎峰[1] 张广防[3] CAI Qingxiang;ZHAO Min;LI Yuhui;HUANG Yankui;LI Feng;ZHANG Guangfang

机构地区：[1]广州中医药大学第一附属医院麻醉科,广东广州510405 [2]青岛市海慈医疗集团,山东青岛266033 [3]广东省中医院,广东广州5101

出　　处：《新中医》2020年第19期122-125,共4页New Chinese Medicine

基　　金：广东省中医药局科研项目(20181098);广东省科技计划项目(20160226)。

摘　　要：目的:观察经皮电刺激足三里穴和内关穴对腹腔镜下肠癌根治术患者手术后康复情况的影响。方法:选择择期行腹腔镜下肠癌根治手术的患者50例,随机分为2组,研究组24例(其中1例未能完成全部试验),对照组25例;2组麻醉方案相同,研究组手术前30 min及术后第1天、第2天给予经皮电刺激足三里穴、内关穴治疗,对照组操作同研究组,但不开启电源;记录2组患者手术时间、出血量、复苏室停留时间、肛门首次排气时间、有无术后非切口痛(肩痛、背痛、肋间肌疼痛等)、术后(4 h、12 h、24 h、48 h)切口疼痛视觉模拟评分法(VAS)评分,以及有无术后恶心呕吐(PONV)。结果:治疗后,研究组患者首次排气时间明显短于对照组,差异有统计学意义(P<0.05);而2组患者手术时间、复苏室停留时间及出血量比较,差异无统计学意义(P>0.05)。术后第1天、第2天,研究组无PONV的病例明显多于对照组,差异均有统计学意义(P<0.05)。经皮穴位电刺激干预后,研究组没出现非切口疼痛的病例明显多于对照组,差异有统计学意义(P<0.05)。术后24 h、48 h,研究组疼痛VAS评分较同组前一时间点明显下降,差异有统计学意义(P<0.05);且研究组VAS评分明显低于对照组同时间点(P<0.05)。结论:经皮电刺激足三里穴和内关穴可明显改善腹腔镜下肠癌根治术患者术后的镇痛效果,减少术后非切口痛的发生,改善术后恶心呕吐,提早排气时间,对加速术后康复有一定的促进作用。Objective:To observe the effect of transcutaneous electrical stimulation at Zusanli(ST 36) and Neiguan(PC 6)on rehabilitation of patients after radical resection for colorectal cancer under laparoscopy. Methods:A total of 50 cases of patients undergoing elective radical resection for colorectal cancer under laparoscopy were randomly divided into the study group and the control group, 24 and 25 cases in each group respectively. One case of patient in the study group did not complete all the experimental observation. Both groups had the same anesthesia scheme., Transcutaneous electrical stimulation at Zusanli(ST 36) and Neiguan(PC 6) was conducted in the study group 30 minutes before surgery as well as on the1 st and 2 nd days after surgery;the control group shared the same operation with that in the study group,but the power of the stimulation was off. The surgery time,bleeding volume,the stay time in post anesthesia care unit,the time of first anal exsufflation,postoperative non-incision pain such as shoulder pain,backache,and pain in intercostal muscle,scores of Visual Analogue Scale(VAS) for evaluating incision pain on the 4 th,12 th,24 th,and 48 thhours after surgery,and postoperative nausea and vomiting(PONV) were recorded in the two groups. Results:After treatment,the time of first exsufflation in the study group was significantly shorter than that in the control group, the difference being significant(P<0.05);when compared the surgery time,the stay time in post anesthesia care unit,and bleeding volume between the two groups,there was no significance in the difference(P>0.05). On the 1 st and 2 nd days after surgery,the cases without PONV in the study group were significantly more than those in the control group, differences being significant(P<0.05). After TEAS intervention,the cases without non-incision pain in the study group were significantly more than those in the control group,the difference being significant(P<0.05). In the 24 thand 48 thhours after surgery,the VAS scores for evaluating pain in the s

关 键 词：腹腔镜下肠癌根治术 加速康复外科 经皮穴位电刺激 辅助麻醉 

分 类 号：R735.3[医药卫生—肿瘤]