经皮穴位电刺激对肺癌术后静脉血栓形成的影响:随机对照研究  

Effect of transcutaneous electrical acupoint stimulation on venous thrombosis after lung cancer surgery: a randomized controlled trial

作　　者：孙月 庞永慧[2] 茅乃权[1] 罗洁宁[1] 蔡道玲 陈菲菲 SUN Yue;PANG Yong-hui;MAO Nai-quan;LUO Jie-ning;CAI Dao-ling;CHEN Fei-fei(Department of Thoracic Surgery,Tumor Hospital Affiliated to Guangxi Medical University,Nanning 530021,China;Nursing Specialist Steering Group,Tumor Hospital Affiliated to Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院胸外科,南宁530021 [2]广西医科大学附属肿瘤医院,护理专家督导组,南宁530021

出　　处：《中国针灸》2020年第12期1304-1308,共5页Chinese Acupuncture & Moxibustion

基　　金：广西壮族自治区卫生和计划生育委员会立项科研项目:Z20180620、Z20190474;广西壮族自治区中医药管理局广西中医药适宜技术开发项目:GZSY20-19。

摘　　要：目的:在常规护理、早期功能锻炼基础上,观察经皮穴位电刺激(TEAS)对肺癌术后患者静脉血栓形成及生存质量的影响。方法:将120例确诊为非小细胞肺癌并初次行肺癌根治术的患者随机分为常规护理组、康复训练组和TEAS组,每组40例。常规护理组采用常规护理;康复训练组于手术日患者清醒后采用常规护理配合早期功能锻炼,每次20 min,上午、下午各1次,共锻炼5 d;TEAS组在康复训练组的基础上联合TEAS刺激足三里、血海、三阴交等穴,疏密波,频率30 Hz/100 Hz,强度以患者耐受为宜,每次30 min,上午、下午各1次,共治疗5 d。观察各组患者术后第5天静脉血栓发生率,于术前、术后第5天进行Caprini血栓风险评估,采用Karnofsky行为状态量表(KPS)及肺癌治疗功能评价量表(FACT-L)进行生存质量评价。结果:术后第5天,TEAS组未见血栓发生,血栓发生率低于常规护理组的15.0%(6/40,P<0.05)。术后第5天,各组患者Caprini评分均升高(P<0.01),但TEAS组低于常规护理组(P<0.05);各组患者KPS评分均降低(P<0.01),但TEAS组、康复训练组均高于常规护理组(P<0.01,P<0.05);各组患者FACT-L各分项评分及总分均降低(P<0.05),但TEAS组FACT-L总分和肺癌特异性模块评分均高于常规护理组(P<0.05)。结论:在常规护理、早期功能锻炼的基础上,TEAS可减少肺癌术后患者静脉血栓发生率,有效预防血栓形成,提高患者生存质量。Objective To observe the effect of transcutaneous electrical acupoint stimulation(TEAS) on venous thrombosis and quality of life after lung cancer surgery, basing on the conventional nursing and early functional exercise. Methods A total of 120 patients diagnosed as non-small cell lung cancer(NSCLC) and received radical resection of lung cancer surgery for the first time were randomized into a conventional nursing group, a rehabilitation training group and a TEAS group, 40 cases in each group. Conventional nursing was adopted in the conventional nursing group. Conventional nursing combined with early functional exercise were adopted in the rehabilitation training group, the exercise was taken 20 min each time, once in both morning and afternoon for 5 days. On the basis of the treatment in the rehabilitation training group, TEAS was applied at Zusanli(ST 36), Xuehai(SP 10), Sanyinjiao(SP 6), etc. in the TEAS group, with disperse-dense wave in frequency of 30 Hz/100 Hz and tolerable intensity, 30 min each time, once in both morning and afternoon for 5 days. The incidence of venous thrombosis in each group was observed at the 5 th day after surgery. Before surgery and at the 5 th day after surgery, the Caprini thrombus risk assessment was performed, the Karnofsky performance status(KPS) scale and the functional assessment of cancer therapy-lung(FACT-L) were used to evaluate the quality of life. Results At the 5 th day after surgery, no thrombosis was found in the TEAS group, the incidence of venous thrombosis in the TEAS group was lower than 15.0%(6/40) in the conventional nursing group(P<0.05). At the 5 th day after surgery, the Caprini scores were increased in the 3 groups(P<0.01), while that in the TEAS group was lower than the conventional nursing group(P<0.05);the KPS scores were decreased in the 3 groups(P<0.01), while those in the TEAS group and the rehabilitation training group were higher than the conventional nursing group(P<0.01, P<0.05);the total scores and the subitem scores of FACT-L were decreased in

关 键 词：非小细胞肺癌 经皮穴位电刺激 静脉血栓 生存质量 随机对照试验 

分 类 号：R246.2[医药卫生—针灸推拿学]