经皮穴位电刺激对ICU重型脑损伤患者肠内营养的影响  

Effect of Transcutaneous Electrical Acupoint Stimulation on Enteral Nutrition in ICU Patients with Severe Traumatic Brain Injury

作　　者：卢乐苗[1] 田昕[1] LU Lemiao;TIAN Xin(Lishui Municipal Central Hospital,Lishui 323000,China)

机构地区：[1]丽水市中心医院,丽水323000

出　　处：《上海针灸杂志》2022年第8期786-789,共4页Shanghai Journal of Acupuncture and Moxibustion

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)特定穴对重症监护室(ICU)重型颅脑损伤(sTBI)患者肠内营养(EN)的影响。方法将60例在ICU中的sTBI患者随机分为治疗组(30例)和对照组(30例)。对照组在入院后24-48 h内开始实施EN,治疗组在对照组EN基础上采用TEAS特定穴治疗。观察两组治疗期间发生的腹部和胃肠道症状、治疗前后营养指标和格拉斯哥昏迷量表(GCS)评分的变化、达到目标喂养量的时间及ICU住院的时间。结果治疗期间,治疗组患者腹部和胃肠道症状(胃肠道出血、腹腔内高压、腹泻和下消化道麻痹)的发生率显著低于对照组(P<0.05)。治疗后,治疗组血红蛋白、血清总蛋白、前白蛋白指标高于对照组(P<0.05),治疗组GCS评分明显高于对照组(P<0.05),治疗组患者达到目标喂养量的时间明显早于对照组(P<0.05)。治疗组患者ICU住院时间明显少于对照组(P<0.05)。结论在实施肠内营养基础上,经皮穴位电刺激可减少重型颅脑损伤患者腹部和胃肠道症状,促进患者营养的改善,减轻患者的昏迷程度,提高喂养效率,缩短患者的ICU住院时间。Objective To observe the effect of transcutaneous electrical acupoint stimulation(TEAS)on enteral nutrition(EN)in patients with severe traumatic brain injury(sTBI)in the intensive care unit(ICU).Method Sixty s TBI patients in ICU were randomized into a treatment group(30 cases)and a control group(30 cases).The control group was offered EN within 24-48 h after admission,and the treatment group received additional TEAS to specific points.Abdominal and gastrointestinal symptoms that occurred during the treatment,nutritional indexes and Glasgow coma scale(GCS)score before and after the treatment,time to reach the feeding target,and the length of ICU stay were observed.Result During the treatment,the incidence of abdominal and gastrointestinal symptoms(gastrointestinal bleeding,intraperitoneal hypertension,diarrhea,and paralysis of the lower gastrointestinal tract)was significantly lower in the treatment group than in the control group(P<0.05).After the treatment,the levels of hemoglobin,total serum protein,and prealbumin were higher in the treatment group than in the control group(P<0.05),and the GCS score in the treatment group was markedly higher than that in the control group(P<0.05).The treatment group took a notably shorter time to reach the feeding target than the control group(P<0.05).The length of ICU stay was significantly shorter in the treatment group than in the control group(P<0.05).Conclusion When EN is applied,TEAS can reduce abdominal and gastrointestinal symptoms,boost nutrition improvement,increase feeding efficiency,and shorten the ICU stay of patients with sTBI.

关 键 词：穴位疗法 经皮穴位电刺激 特定穴 颅脑损伤 肠内营养 重症监护 

分 类 号：R246.6[医药卫生—针灸推拿学]