术前双侧内关穴经皮电刺激对剖宫产产妇恶心呕吐及血浆胃泌素的影响  

Effect of preoperative transcutaneous electrical stimulation at bilateral Neiguan Point on nausea,vomiting and plasma gastrin in parturients with cesarean section

作　　者：周维德 宗雨 杨歆璐 汪珊 谢言虎 柴小青 ZHOU Weide;ZONG Yu;YANG Xinlu;WANG Shan;XIE Yanhu;CAI Xiaoqing(Department of Anesthesiology,First Affiliated Hospital of University of Science and Technology of China,Hefei,Anhui 230001,China)

机构地区：[1]中国科学技术大学附属第一医院麻醉科,合肥230001

出　　处：《重庆医学》2021年第16期2770-2773,共4页Chongqing medicine

基　　金：安徽省2018年度重点研究与开发计划项目(1804h08020286)。

摘　　要：目的观察术前双侧内关穴经皮穴位电刺激对剖宫产产妇恶心呕吐发生率的影响。方法选择该院2016年7月至2017年4月择期行剖宫产术患者120例,采用随机数字表法分为对照组(60例)和TAES组(60例),TAES组于术前给予经皮电刺激双侧内关穴30 min,对照组仅在双侧内关穴粘贴电极片但不予电刺激,两组均采用连续硬膜外麻醉,术后镇痛方法均保持一致。于穴位刺激前、经皮电刺激30 min后、术毕、术后24 h时采集外周静脉血,测定血浆胃泌素(GAS)水平,记录麻醉开始至胎儿取出(T1)、胎儿取出至子宫缝合完毕(T2)、探查腹腔至手术结束(T3)、术后0~<2 h(T4)、术后2~<6 h(T5)、术后6~<24 h(T6)、术后24 h(T7)恶心呕吐发生情况。结果共112例患者完成试验,对照组57例,TAES组55例。对照组和TAES组分别有30例(52.6%)和13例(23.6%)发生恶心呕吐。与对照组相比,TAES组在T3、T4及T7时段恶心呕吐发生率降低,差异均有统计学意义(P<0.05)。与对照组相比,TAES组在经皮电刺激30 min后、术毕、术后24 h时血浆GAS水平下降,差异均有统计学意义(P<0.05)。结论术前经皮电刺激双侧内关穴可降低剖宫产高危患者术中探查腹腔后及术后早期恶心呕吐发生率,其机制可能与降低血浆GAS水平有关。Objective To observe the effect of preoperative bilateral Neiguan Point transcutaneous acupoint electrical stimulation(TAES)on the occurrence rate of nausea and vomiting in parturients with cesarean section.Methods One hundred and twenty cases of parturients who underwent elective cesarean section in this hospital from July 2016 to April 2017 were selected and divided into the control group(n=60)and TAES group(n=60)by adopting the random number table method.The TAES group preoperatively adopted TAES at bilateral Neiguan Point lasted for 30 min,and the control group only pasted the electrodes slice at bilateral Neiguan Point without giving the electrical stimulation.The both groups adopted the continuous epidural anesthesia,and postoperative analgesia method remained consistent.The peripheral venous blood was collected before TAES,at 30 min after TAES,the end of operation and 24 h after operation.The plasma gastrin(GAS)level was detected.The occurrence of nausea and vomiting was recorded at time from anesthesia begin to the fetus removal(T1),from the fetus removal to the uterine suture end(T2),from abdominal exploration to operation end(T3),at 0-2 h(T4),2-6 h(T5),6-24 h(T6)and 24 h(T7)after operation.Results A total of 112 cases completed the experiment,57 cases in the control group and 55 cases in the TAES group.The nausea and vomiting occurred in 30 cases(52.6%)in the control group and 13 cases(23.6%)in the TAES group.Compared with the control group,the incidence rate of nausea and vomiting at T3,T4 and T7 in the TAES group were decreased,and the differences were statistically significant(P<0.05).Compared with the control group,the plasma GAS levels at 30 min after TAES,the end of operation and 24 h after operation inthe TAES group were decreased,and the differences were statistically significant(P<0.05).Conclusion Preoperative transcutaneous TAES at bilateral Neiguan Point can decrease the occurrence rate of nausea and vomiting in intraoperative abdominal exploration and during the postoperative early stage in

关 键 词：剖宫产术 内关穴 经皮电刺激神经疗法 恶心呕吐 胃泌素 

分 类 号：R246.2[医药卫生—针灸推拿学]