经皮穴位电刺激对体外循环心脏手术患者术后恢复质量的影响  

Effect of transcutaneous electrical acupoint stimulation on early postoperative quality of recovery in patients undergoing cardiopulmonary bypass cardiac surgery

作　　者：马亚飞[1] 冯毅[1] 魏利娟[1] 陈小莉[1] 郭仲辉[1] MA Yafei;FENG Yi;WEI Lijuan;CHEN Xiaoli;GUO Zhonghui(The First Affiliated Hospital and College of Clinical Medicine/Henan University of Science and Technology,Luoyang,Henan 471000,China)

机构地区：[1]河南科技大学临床医学院/河南科技大学第一附属医院,河南洛阳471000

出　　处：《现代医药卫生》2024年第20期3471-3474,3480,共5页Journal of Modern Medicine & Health

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200596)。

摘　　要：目的探讨经皮穴位电刺激(TEAS)对体外循环心脏手术患者术后恢复质量的影响。方法选择2022年3—12月拟行心脏瓣膜置换术的患者60例作为研究对象,采用随机数字表法将其分为对照组和观察组,各30例。观察组于麻醉诱导前30 min至术毕及术后3 d行TEAS双侧合谷、内关、神门、中府、云门和大包穴,每天2次,每次30 min;对照组穴位选择同观察组,仅接电针刺激仪但不给予刺激。比较2组患者术前1 d,术后1、2、3 d 40项恢复质量评分量表(QoR-40)评分和失眠严重程度指数量表(ISI)评分;术后机械通气时间、重症监护病房(ICU)停留时间;拔除气管插管后24 h恶心呕吐发生率、患者静脉自控镇痛(PCIA)有效按压次数、PCIA按压总次数和补救镇痛率。结果观察组术后1、2、3 d时QoR-40量表总评分及情绪状态、身体舒适和疼痛评分较对照组升高,ISI评分较对照组降低,差异均有统计学意义(P<0.05)。观察组术后机械通气时间、ICU停留时间及拔除气管插管后24 h恶心呕吐发生率、PCIA有效按压次数、PCIA按压总次数和补救镇痛率较对照组均降低,差异均有统计学意义(P<0.05)。结论围手术期TEAS双侧内关、神门、合谷、中府、云门和大包穴,可改善心脏直视手术患者术后早期的恢复质量,缩短术后机械通气时间和ICU停留时间,减轻术后疼痛和恶心呕吐。Objective To explore the effect of transcutaneous electrical acupoint stimulation on early postoperative quality of recovery in patients undergoing cardiopulmonary bypass cardiac surgery.Methods A total of 60 patients who undergoing cardiac valve replacement surgery from March to December 2022 were randomly divided into the control group and the observation group by using the randomized number table method,with 30 patients in each group.In the observation group,TEAS was performrd on bilateral Hegu,Neiguan,Shenmen,Zhongfu,Yunmen,and Dabao acupoints 30 minutes before anesthesia induction to completion,1 day,2 days and 3 days after operation,twice a day for 30 minutes each time.In the control group,the electrodes were only connected at the same time point without electrical stimulation.Two groups of patients were compared in terms of the quality of recovery-40 questionnaire(QoR-40)scores and the insomnia severity index(ISI)scores at 1 day before surgery,1 day,2 days and 3 days after operation;postoperative mechanical ventilation time and ICU stay time;the incidence of postoperative nausea and vomiting,the effective number of patient controlled intravenous analgesia(PCIA)compressions,the total number of PCIA compressions,and the salvage analgesia rate after 24 hours of tracheal intubation removal.Results Compared with control group,the total score of QoR-40,thescales of emotional state,physical comfortand pain scores were increased,while the score of ISI was decreased in observation group at 1 day,2 days and 3 days after operation,with statistical significance(P<0.05).The postoperative mechanical ventilation time,ICU stay time,the incidence of postoperative nausea and vomiting,the effective number of patient controlled intravenous analgesia(PCIA)compressions,the total number of PCIA compressions,and the salvage analgesia rate were lower in observation group after 24 hours of tracheal intubation removal,with statistical significance(P<0.05).Conclusion Perioperative TEAS at bilateral Neiguan,Shenmen,Hegu,Zhongfu,Yunmen

关 键 词：经皮穴位电刺激 体外循环 术后恢复质量 心脏手术 心脏瓣膜病 

分 类 号：R614[医药卫生—麻醉学]