经皮穴位电刺激对妇科腹腔镜术后早期康复的影响OA
Effect of transcutaneous electrical acupoint stimulation on early postoperative recovery after gynecological laparoscopic surgery
目的 观察在围术期应用经皮穴位电刺激(transcutaneous electrical acupoint stimulation,TEAS)联合加速康复外科(enhanced recovery after surgery,ERAS)模式对妇科腹腔镜手术患者术后早期康复的影响.方法 选择择期腹腔镜下妇科良性肿物切除手术患者 80 例,随机分为观察组(T 组)和对照组(C 组),每组 40 例,两组均实施ERAS模式.T组围术期应用 TEAS;C 组电极片粘贴的穴位、时间点与T 组相同,但未予电刺激.观察两组术前焦虑量表(preoperative anxiety scale-7,PAS-7)评分、术中瑞芬太尼消耗量和血压平稳指数、切皮后 30 min 血糖较基础值降低值、术后疼痛视觉模拟量表(visual analog scale,VAS)评分、术后恶心呕吐(postoperative nausea and vomiting,PONV)VAS 评分、术后当夜匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分、腹胀发生率、术后首次排气时间及术后 24 h 的 15 项恢复质量(quality of recovery-15,QoR-15)评分.结果 与 C 组比较,T 组手术日早晨 PAS-7 评分、术中瑞芬太尼消耗量、血压平稳指数低(P＜0.05);T组术后30 min、术后6 h及术后24 h疼痛及PONV的VAS评分均显著低于C组(P＜0.05);T组术后当夜PSQI评分及腹胀发生率均低于C组(P＜0.05);术后24 h的QoR-15评分高于C组(P＜0.05);术后首次排气时间较C组缩短(P＜0.05).结论 在围术期应用TEAS联合ERAS模式可缓解妇科腹腔镜手术患者术前焦虑,减少术中瑞芬太尼用量,减轻术后疼痛程度,加快术后胃肠功能的恢复,改善睡眠质量,提高患者舒适度和术后早期康复质量.
Objective To observe the effects of perioperative application of transcutaneous electrical acupoint stimulation(TEAS)combined with the enhanced recovery after surgery(ERAS)protocol on early postoperative recovery in patients undergoing gynecological laparoscopic surgery.Method Eighty patients scheduled for elective laparoscopic resection of benign gynecological tumors were randomly assigned to an observation group(TEAS group,T group)and a control group(C group),with 40 patients in each group.Both groups were managed under the ERAS protocol.In the T group,TEAS was applied perioperatively;in the C group,electrode pads were placed at the same acupoints and time points as in the T group,but without electrical stimulation.The preoperative anxiety scores;intraoperative remifentanil consumption;intraoperative blood pressure stability index;reduction in blood glucose levels 30 min after skin incision compared with baseline;postoperative pain visual analog scale(VAS)scores;postoperative nausea and vomiting(PONV)VAS scores;Pittsburgh sleep quality index(PSQI)score on the night after surgery;incidence of abdominal distension;time to first postoperative flatus;and quality of recovery-15(QoR-15)score at 24 h postoperatively were observed.Result Compared with the C group,the T group showed significantly lower preoperative anxiety scores on the morning of surgery,reduced intraoperative remifentanil consumption,and a lower blood pressure stability index(P＜0.05).Postoperative pain and PONV VAS scores at 30 min,6 h,and 24 h after surgery were significantly lower in the T group than in the C group(P＜0.05).The PSQI score on the night after surgery and the incidence of abdominal distension were also lower in the T group(P＜0.05).The QoR-15 score at 24 h postoperatively was higher in the T group(P＜0.05),and the time to first postoperative flatus was significantly shorter than that in the C group(P＜0.05).Conclusion Perioperative application of TEAS combined with the ERAS protocol can alleviate preoperative anxiety,reduce intraoperative remifentanil consumption,relieve postoperative pain,accelerate recovery of gastrointestinal function,improve sleep quality,enhance patient comfort,and promote early postoperative recovery in patients undergoing gynecological laparoscopic surgery.
陈丽;朱静德;刘欢欢;黄捷思;吕东森;康力;姜斌;张春如
广东省深圳市宝安区中医院,深圳 518133黑龙江省牡丹江市中医医院,牡丹江 157005广东省深圳市宝安区中医院,深圳 518133广东省深圳市宝安区中医院,深圳 518133广东省深圳市宝安区中医院,深圳 518133广东省深圳市宝安区中医院,深圳 518133黑龙江省牡丹江市中医医院,牡丹江 157005广东省深圳市宝安区中医院,深圳 518133
医药卫生
穴位疗法电刺激疗法经皮穴位电刺激术后加速康复妇科腹腔镜手术后并发症
Acupoint therapyElectrical stimulation therapyTranscutaneous electrical acupoint stimulationEnhanced recovery after surgeryGynecologyLaparoscopyPostoperative complications
《上海针灸杂志》 2026 (5)
485-490,6
深圳市宝安区科技创新局科研立项项目(2021JD193)
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