TEAS特定穴对ICU重度创伤性脑损伤患者胃肠低动力的改善效果  

Effects of transcutaneous electrical acupoint stimulation specific points on improving low gastrointestinal motility in intensive care unit patients with severe traumatic brain injury

作　　者：卢乐苗[1] 田昕[2] Lu Lemiao;Tian Xin(Department of Acupuncture and Moxibustion,Lishui Municipal Central Hospital,Lishui 323000,Zhejiang,China;Department of Critical Care Medicine,Lishui Municipal Central Hospital,Lishui 323000,Zhejiang,China)

机构地区：[1]丽水市中心医院针灸科,浙江丽水323000 [2]丽水市中心医院重症医学科,浙江丽水323000

出　　处：《中国中西医结合急救杂志》2021年第4期412-415,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省丽水市公益性技术应用研究项目(2019GYX19);浙江省中医药科技计划项目(2020ZB299)。

摘　　要：目的观察经皮穴位电刺激(TEAS)特定穴对重症监护病房(ICU)重度创伤性脑损伤(TBI)患者胃肠低动力的改善效果。方法选择丽水市中心医院2018年1月至2019年12月ICU收治的64例重度TBI患者,采用随机数字表法分为常规治疗组和TEAS特定穴治疗组,每组各32例。常规治疗组在发生胃肠动力障碍后予以胃复安针对症处理,TEAS特定穴治疗组此基础上:加用TEAS特定穴治疗,特定穴选取双侧足三里、上巨虚、天枢、内关和合谷穴。观察两组患者达到日标喂养量的时间、首次排出含活性炭粪便的时间、比较两组患者治疗10 d后急性胃肠损伤(ACI)分级改变情况以及胃肠道相关并发症发生率。结果TEAS特定穴治疗组患者治疗后达到目标喂养量的时间以及首次排出含活性炭类便的时间明显早于常规治疗组(达到目标喂养量的时间(d):4.09±1.57比6.78±1.72,首次排出含活性炎粪便的时间(d):5.69±1.62比7.03±1.77.均P<0.05]。TEAS特定穴治疗组患者治疗10d后,ACI分级情况明显优于常规治疗组。TEAS特定穴治疗组患者发生胃肠道出血、腹腔内高压、腹泻、下消化道麻痹等胃肠道相关并发症的比例均明显低于常规治疗组[胃肠道出血:3.12%(1/32)比25.00%(8/32),腹腔内高压:15.62%(5/32)比43.75%(14/32),腹泻:9.37%(3/32)比34.37%(1132),下消化道麻痹:6.25%(2/32)比40.62%(13/32),均P<0.05]。结论TEAS特定穴能改善ICU重度TBI患者胃肠低动力情况,降低ACI分级水平以及肠内营养(EN)胃肠道相关并发症的发生率。Objective To olsene the ffets of transrutanerous reetrieal arupoint stimulation(TEAS)sperifire points on improving low gastrintestinal motility in patients with severe traumatic brain injury(TBI)in intensive rare unit(CU).Methods Sixly-four patients with severe TBI treated in ICU of lLishui Municipal Central Hospital from Jamuary 2018 to December 2019 were randomly divided into routine treatment group and TEAS specife points treatment group,with 32 cases in rach group.The patiernts in the routine treatment group wer trated with Metoclopramide injection afer the orrurrenrr of gastrointestinal motility disorder,and on this basis.patienls in the TEAS speifie points Ireatment group were treated additionally by using TEAS at speife acupoints.as bhilateral Zusanli.Shangjuxu.Tianshu.Neiguan and Hegu.The time of reaching the feeding targe!and the first exeretion of feces with aetivated carbon,after 10 days of treatment,the changes of arute gastrointestinal injury(ACI)grade and the incidences of gastrointestinal adverse reactions were compared between the patients in the 1wo groups.Results After treatment.the time of reaching the feeding target and the first exeretion of feces with activated carbon of the patients in the TEAS sprrifie points Ireatment group were signifieantly earlier than those in the routine treatment group[the time of reaching the feeding target(days):4.09±1.57 vs.6.78±1.72.the time of first exeretion of fees with artivated carbon(days):5.69±1.62 vs.7.03±1.77.both P<0.05].After 10 days of Ireatment,the ACI grade of the patients in the TEAS speife point Ireatment group was obv iously lower or superior to that in the routine treatment group.The incidences of gastrointestinal adverse reactions such a gastrointestinal bleeding.inra-abrdominal cavity hypertension.diarrhea and lower gastrointestinal paralysis of the patients in the TEAS speeifir point treatmernt group were significanly lower than those in the routine Ireatment group lgastrointesinal bleeding:3.12%(1/32)vs.25.00%(8/32).intra-abndominal cav

关 键 词：胃肠动力障碍 经皮穴位电刺激 特定穴 重度创伤性脑损伤 

分 类 号：R24[医药卫生—中医临床基础]