经皮穴位电刺激对全麻手术患者拔管期应激反应影响的meta分析  

Meta-analysis of effect of transcutaneous electric acupoint stimulation on stress response of patients undergoing general anesthesia during extubation

作　　者：党梦菡 刘发妮 张可京 李国艳 李春黇 汤雯倩 贾悦 Dang Menghan;Liu Fani;Zhang Kejing;Li Guoyan;Li Chuntian;Tang Wenqian;Jia Yue(Department of Anesthesiology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院麻醉科,100700 [2]北京中医药大学东直门医院针灸科,100700 [3]北京中医药大学东直门医院检验科,100700 [4]北京中医药大学东方医院心血管内科

出　　处：《北京医学》2025年第2期127-137,共11页Beijing Medical Journal

摘　　要：目的探讨经皮穴位电刺激(transcutaneous electric acupoint stimulation,TEAS)对全麻手术患者拔管期应激反应的影响。方法选取建库至2023年12月中国知网、万方数据库、维普、Pub Med、CBM、Web of Science等数据库公开发表的TEAS辅助全麻手术效果的随机对照研究。对所有文献进行筛选、整理和分析后,采用Cochrane偏倚风险评估对文献进行质量评价,采用Rev Man 5.3统计软件分析TEAS对全麻手术患者拔管期应激反应的影响。结果共检索430篇文献,最终纳入14篇,涉及1057例患者,其中TEAS组528例,对照组529例。Meta分析结果显示,与对照组相比,TAES组拔管期MAP(MD=-8.80,95%CI:-10.43~-7.17,P<0.01,I2=78%)、HR(MD=-8.50,95%CI:-10.18~-6.83,P<0.01,I2=79%)、去甲肾上腺素(MD=-98.23,95%CI:-128.39~-68.07,P<0.01,I2=99%)、血浆肾上腺素(MD=-27.14,95%CI:-32.74~-21.55,P<0.01,I2=99%)、皮质醇浓度(MD=-112.25,95%CI:-137.67~-86.83,P<0.01,I2=99%)及恶心呕吐发生率(MD=0.30,95%CI:0.22~0.42,P<0.01,I2=0%)均降低。结论围手术期TEAS能够有效改善全麻手术患者拔管期应激反应,稳定血流动力学,降低术后不良反应发生率。Objective To explore the effect of transcutaneous electric acupoint stimulation(TEAS)on the stress response of patients undergoing general anesthesia surgery during extubation.Methods Randomized controlled trials of TEAS-assisted general anesthesia surgery published in databases such as China National Knowledge Infrastructure,Wanfang Database,VIP,PubMed,CBM,and Web of Science from the establishment of the database to December 2023 were selected.After screening,sorting and analyzing all the literatures,the quality of the literatures was evaluated by Cochrane risk of bias assessment,and the effect of TEAS on the stress response of patients undergoing general anesthesia surgery during extubation were analyzed by RevMan 5.3 statistical software.Results A total of 430 articles were retrieved,and 14 articles were ultimately included,involving 1057 patients,and 528 patients in the TAES group and 529 patients in the control group.The meta-analysis results showed that compared with the control group,the patients in the TEAS group had lower MAP during extubation(MD=-8.80,95%CI:-10.43--7.17,P<0.01,I2=78%),HR(MD=-8.50,95%CI:-10.18--6.83,P<0.01,I2=79%),norepinephrine(MD=-98.23,95%CI:-128.39--68.07,P<0.01,I2=99%),plasma epinephrine(MD=-27.14,95%CI:-32.74--21.55,P<0.01,I2=99%),cortisol concentration(MD=-112.25,95%CI:-137.67--86.83,P<0.01,I2=99%),and the incidence of nausea and vomiting(MD=0.30,95%CI:0.22-0.42,P<0.01,I2=0%).Conclusions Perioperative TEAS can effectively improve the stress response of patients undergoing general anesthesia surgery during extubation,stabilize hemodynamics,and reduce the incidence of postoperative adverse reactions.

关 键 词：经皮穴位电刺激 全麻 拔管期 应激反应 META分析 

分 类 号：R614[医药卫生—麻醉学]