经皮穴位电刺激对鼻内镜手术患者术后恢复质量的影响:随机对照试验  

Effect of transcutaneous electrical acupoint stimulation on postoperative recovery quality in patients undergoing endoscopic sinus surgery:a randomized controlled trial

作　　者：赵倩文 苏丹丹 汪美如 闫莉[3] 孙斌 高飞 孟宣 王立伟 ZHAO Qianwen;SU Dandan;WANG Meiru;YAN Li;SUN Bin;GAO Fei;MENG Xuan;WANG Liwei(Xuzhou Clinical Medical College,Xuzhou Medical University,Xuzhou 221004,Jiangsu Province,China;School of Anesthesiology,Xuzhou Medical University;Department of Anesthesiology,Xuzhou Central Hospital,Xuzhou 221009,Jiangsu Province;Department of Acupuncture and Cerebrovascular Diseases,Xuzhou Hospital of TCM)

机构地区：[1]徐州医科大学徐州临床学院,江苏徐州221004 [2]徐州医科大学麻醉学院 [3]徐州市中心医院麻醉科,江苏徐州221009 [4]徐州市中医院针灸脑病科

出　　处：《中国针灸》2024年第10期1133-1138,共6页Chinese Acupuncture & Moxibustion

基　　金：江苏省医学重点实验室建设项目:JSDW202231;江苏省老年健康科研重点课题项目:LKZ2023016;徐州市医学领军人才培养项目:XWRCHT20210033;彭城英才医学青年后备人才培养项目:XWRCSL20220135。

摘　　要：目的:观察经皮穴位电刺激(TEAS)对择期鼻内镜手术患者术后恢复情况及疼痛的影响。方法:将106例接受择期鼻内镜手术患者随机分为观察组和对照组,每组53例。两组患者于静脉麻醉诱导前30 min至手术结束分别给予TEAS或安慰TEAS,穴位均选取双侧内关和足三里。于手术前1 d(T_(0))、手术后1 d(T_(1))、手术后2 d(T_(2))、手术后3 d(T_(3)),观察两组15项恢复质量(Qo R-15)量表评分;于T_(1)、T_(2)、T_(3),观察两组疼痛视觉模拟量表(VAS)评分;于T_(0)、T_(1)、T_(2)、T_(3),观察两组阿森斯失眠量表(AIS)评分;记录两组术后恶心呕吐和头晕头痛的发生率,补救镇痛药使用情况和镇痛泵按压次数,以及拔管时间。结果:T_(1)、T_(2)、T_(3)时,观察组患者Qo R-15量表评分高于对照组(P<0.01,P<0.001),AIS评分低于对照组(P<0.001)。T_(1)、T_(2)时,观察组患者疼痛VAS评分低于对照组(P<0.001)。观察组术后恶心呕吐和头晕头痛的发生率分别为24.5%(13/53)、37.7%(20/53),分别低于对照组的56.6%(30/53)、66.0%(35/53,P<0.01)。两组患者术后补救镇痛药使用率及镇痛泵按压次数比较,差异无统计学意义(P>0.05)。观察组拔管时间短于对照组(P<0.001)。结论:经皮穴位电刺激能够提高接受择期鼻内镜手术患者术后恢复质量,缓解术后疼痛,改善术后睡眠质量,降低术后恶心呕吐发生率。Objective To observe the effects of transcutaneous electrical acupoint stimulation(TEAS)on postoperative recovery and pain in patients undergoing elective endoscopic sinus surgery.Methods One hundred and six patients scheduled for elective endoscopic sinus surgery were randomly divided into an observation group and a control group,with53 patients in each group.Patients in both groups received TEAS or sham TEAS,respectively,from 30 min before intravenous anesthesia induction until the end of surgery.Acupoints selected were bilateral Neiguan(PC 6)and Zusanli(ST 36).The quality of requirements-15(Qo R-15)scores were assessed on the day before surgery(T_(0))and on postoperative days 1(T_(1)),2(T_(2))and 3(T_(3)).Pain visual analogue scale(VAS)scores were recorded at T_(1),T_(2)and T_(3).Athens insomnia scale(AIS)scores were measured at T_(0),T_(1),T_(2)and T_(3)in the two groups.The incidence of postoperative nausea-vomiting and dizziness-headache,usage of analgesics,number of patient-controlled analgesia(PCA)pump presses,and extubating time were also recorded in the two groups.Results At T_(1),T_(2)and T_(3),the observation group had higher Qo R-15 scores(P<0.01,P<0.001)and lower AIS scores(P<0.001)than the control group.At T_(1)and T_(2),the observation group had lower pain VAS scores than the control group(P<0.001).The incidence of postoperative nausea-vomiting and dizziness-headache was 24.5%(13/53)and 37.7%(20/53)in the observation group,which were lower than 56.6%(30/53)and 66.0%(35/53)in the control group(P<0.01).There were no statistically significant differences in the use of rescue analgesics or the number of PCA pump presses between the two groups(P>0.05).The extubating time was shorter in the observation group compared with that in the control group(P<0.001).Conclusion TEAS could improve postoperative recovery quality,alleviate postoperative pain,improve sleep quality,and reduce the incidence of postoperative nausea and vomiting in patients undergoing elective endoscopic sinus surgery.

关 键 词：鼻内镜手术 经皮穴位电刺激 术后恢复质量 疼痛 内关 足三里 

分 类 号：R246.81[医药卫生—针灸推拿学]