经皮穴位电刺激对腹腔镜宫颈癌根治术后疼痛、胃肠功能及血浆炎症因子的影响  

Effects of TEAS on Pain,Gastrointestinal Function and Plasma Inflammatory Factors after Radical Hysterectomy of Cervical Cancer under Laparoscope

作　　者：李峰 谷书涵 甘建辉 王承志 崔晓燕 史金麟 张元明 LI Feng;GU Shuhan;GAN Jianhui;WANG Chengzhi;CUI Xiaoyan;SHI Jinlin;ZHANG Yuanming(Department of Anesthesiology,Tangshan People's Hospital,Tangshan 063000,China)

机构地区：[1]华北理工大学附属唐山市人民医院麻醉科,河北唐山063000

出　　处：《西部中医药》2020年第11期118-122,共5页Western Journal of Traditional Chinese Medicine

摘　　要：目的:探讨经皮穴位电刺激对腹腔镜宫颈癌根治术患者术后疼痛、胃肠功能及血浆炎症因子的影响。方法:将全麻下行腹腔镜宫颈癌根治术的患者120例随机分为试验组和对照组各60例。术后两组患者在给予自控静脉镇痛的同时,试验组术后第1、2天给予双侧合谷、内关、三阴交穴电刺激;对照组给予假电刺激。记录术后4、8、12、24、48h安静及咳嗽时两组患者疼痛视觉模拟评分(visual analog scale,VAS),观察两组患者血浆白细胞介素6(i nt erleukin-6,IL-6)及肿瘤坏死因子α(tumor necrosis fact orα,TNF-α)水平;记录两组患者术后首次排气、进食、排便及术后住院时间;记录两组患者术后48 h静脉自控镇痛泵(PCIA)消耗量及有效按压次数、不良反应发生率。结果:试验组患者安静、咳嗽时VAS评分术后8、12、24、48 h较术后4h及对照组各时间点降低,且术后4 h咳嗽时VAS评分低于对照组;与术后4h比较,试验组术后24、48 h时血浆IL-6水平与术后8、12、24、48h时TNF-α水平均下降,对照组术后8、12、24、48h时IL-6及TF-α水平均下降,差异有统计学意义(P<0.05);试验组术后IL-6及TF-α水平术后4、8、12、24、48 h低于对照组,差异有统计学意义(P<0.05)。术后PCI A泵按压次数及总消耗量试验组低于对照组(P<0.05);试验组患者术后排气、进食及排便时间、术后住院时间短于对照组(P<0.05)。此外,试验组术后恶心呕吐,头晕发生率低于对照组(P<0.05)。结论:腹腔镜宫颈癌根治术后患者行经皮穴位电刺激有助于增强术后镇痛效果,减少镇痛药物需要,降低围术期炎症因子水平,促进术后肠道功能恢复,减少术后不良反应发生率,缩短术后住院时间。Objective: To discuss the effects of TEAS on pain, gastrointestinal function and plasma inflammatory factors after radical hysterectomy for cervical cancer after laparoscope. Methods: All 120 patients who accepted laparoscopic radical hysterectomy for cervical cancer under general anesthesia were randomized into the experiment group and the control group, 60 cases each group. After the operation, the patients in both groups accepted patient-controlled intravenous analgesia(PCIA) simultaneously, the experiment group electrical stimulation of the acupoints including Hegu(LI4), Neiguan(PC6)) and Sanyinjiao(SP6) bilaterally at the first and second day after the operation;the control group false electrical stimulation. To record VAS of both groups when they were quiet and coughed four, eight, 12, 24 and 48 hours after the operation, to observe the levels of IL-6 and TNF-α in the plasma between both groups;to record first exhaust time, food intake time, defecation time and postoperative hospitalization time of both groups;to record the consumption of 48 h patient-controlled intravenous analgesia pump(PCIA) and effective press times and the incidence of adverse reaction of the two groups. Results: VAS scores reduced when the patients at rest and coughing in the experiment group 8, 12, 24 and 48 hours after operation were compared with the group four hours after the operation and the control group at different times, VAS scores of the patients when they were coughing four hours after the operation lowered;compared with four hours after the surgery, the levels of IL-6 24 and 48 hours after the surgery and TNF-α 8, 12, 24 and 48 hours after operation of the experiment group lowered, the levels of IL-6 and TNF-α 8, 12, 24 and 48 hours reduced after operation of the control group, and the difference had statistical meaning(P<0.05);the levels of IL-6 and TNF-α 4, 8, 12, 24 and 48 hours after the surgery of the experiment group were lower than these of the control group, and the difference was statistically significant(P <

关 键 词：宫颈癌 术后镇痛 炎症因子 白细胞介素6 肿瘤坏死因子Α 胃肠功能 经皮穴位电刺激 

分 类 号：R245[医药卫生—针灸推拿学]