经皮穴位电刺激辅助全麻改善腹腔镜胆囊切除患者术后恢复及焦虑抑郁的临床观察  

Clinical Study on the Improvement of Postoperative Recovery and Anxiety-Depression in Patients Undergoing Laparoscopic Cholecystectomy with Transcutaneous Acupoint Electrical Stimulation-Assisted General Anesthesia

作　　者：何川[1] 王杰杰 钱焕丽 HE Chuan;WANG Jie-jie;QLAN Huan-li(Bozhou People's Hospital,Bozhou Anhui 236800)

机构地区：[1]亳州市人民医院,安徽亳州236800

出　　处：《世界中西医结合杂志》2023年第12期2478-2482,2487,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：亳州市人民医院新技术新项目基金(2022ZDB-05)。

摘　　要：目的探讨经皮穴位电刺激(Transcutaneous acupoint electrical stimulation,TEAS)辅助全麻对腹腔镜胆囊切除(Laparoscopic cholecystectomy,LC)患者术后恢复质量及焦虑抑郁情绪的改善作用。方法选取2022年5月7日—2023年4月19日期间亳州市人民医院择期行LC患者150例作为研究对象,按随机数字表法分为TEAS组和全麻组,每组各75例。TEAS组全麻基础上于术前1 d选取印堂穴、双侧内关穴、双侧合谷穴行TEAS治疗30 min、麻醉诱导前60 min开始持续行TEAS至术毕。全麻组在全麻基础上相同时间内仅在相应穴位粘贴电极片,连接电子针疗仪,不进行电刺激。主要观察术前及术后恢复质量(Quality of recovery-15,QoR-15)总分及医院焦虑抑郁量表(Hospital anxiety and depression scale,HADS)评分,次要观察麻醉中瑞芬太尼及丙泊酚用量,静息及咳嗽状态下术后痛视觉模拟评分(Visual analogue score,VAS),术后恶心呕吐(Postoperative nausea and vomiting,PONV)例数,拔管时间及住院时间。结果术后24 h、48 h、72 h两组患者QoR-15评分均较术前降低,差异有统计学意义(P<0.05);术后24 h、48 h TEAS组QoR-15评分均较全麻组明显升高,差异有统计学意义(P<0.05)。术后两组患者HADS评分均较术前降低,差异有统计学意义(P<0.05);术后24 h、48 h TEAS组HADS评分均较全麻组明显降低,差异有统计学意义(P<0.05)。术中TEAS组麻醉药物瑞芬太尼、丙泊酚用量均明显低于全麻组,差异有统计学意义(P<0.05)。术后24 h、48 h,TEAS组静息VAS评分均较全麻组降低,差异有统计学意义(P<0.05)。TEAS组PONV发生率32.00%(24/75)低于全麻组61.33%(46/75),差异有统计学意义(P<0.05);TEAS组拔管时间及住院时间均短于全麻组,差异有统计学意义(P<0.05)。结论TEAS辅助全麻对LC患者术后恢复质量及焦虑抑郁情绪的改善作用显著,还可减少术中麻醉药物用量、缓解术后疼痛、预防PONV并缩短拔管及住院时间。Objective To analyze the effect of transcutaneous acupoint electrical stimulation(TEAS)-assisted general anesthesia on the postoperative quality recovery and alleviation of anxiety-depression in patients undergoing laparoscopic cholecystectomy(LC).Methods One hundred and fifty patients undergoing elective LC at Bozhou People′s Hospital between May 7,2022 and April 19,2023 were selected as the study subjects.The patients were divided into TEAS group and general anesthesia group by random number table method,with 75 cases in each group.In the TEAS group,on the basis of general anesthesia,TEAS was applied to Yintang acupoint,bilateral Neiguan acupoints,and bilateral Hegu acupoints for 30 minutes on the day before the surgery.TEAS was initiated 60 minutes before anesthesia induction and performed until the end of surgery.In the general anesthesia group,on the basis of general anesthesia,electrode sheets were placed on the corresponding acupoints for the same time and connected to the electronic needle therapy instrument,without electrical stimulation.The main observations included the total score of quality of recovery-15(QoR-15)and the score of hospital anxiety and depression scale(HADS)in preoperative and postoperative periods.The secondary observations were the amount of remifentanil and propofol used during anesthesia,the visual analogue score(VAS)of postoperative pain at rest and during coughing,the number of cases of postoperative nausea and vomiting(PONV),the time of extubation,and the length of hospitalization.Results The postoperative QoR-15 scores of both groups of patients decreased remarkably at 24 h,48 h,and 72 h compared with the preoperative scores,and these differences were statistically significant(P<0.05).At 24 h and 48 h postoperatively,the TEAS group exhibited significantly higher QoR-15 scores compared with the general anesthesia group,with statistically significant differences(P<0.05).The postoperative HADS scores of both groups of patients decreased significantly compared to the preoperative

关 键 词：腹腔镜胆囊切除 经皮穴位电刺激 全麻 术后恢复质量 焦虑抑郁情绪 

分 类 号：R575.6[医药卫生—消化系统] R245.97[医药卫生—内科学]