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[电针对全身麻醉下腹腔镜胆囊切除术后患者胃肠功能的影响]

[Effect of electroacupuncture on gastrointestinal function of patients after laparoscopic cholecystectomy under general anesthesia].

作者信息

Pang Run-Hua, Zhu Ya-Qing, Wu Jian, Huang Jun-Hai, Chen Bin

机构信息

Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China.

出版信息

Zhen Ci Yan Jiu. 2022 Jul 25;47(7):640-3. doi: 10.13702/j.1000-0607.20210711.

Abstract

OBJECTIVE

To observe the effects of electroacupuncture at bilateral Zusanli(ST36), Shangjuxu(ST37), and Sanyinjiao (SP6) acupoints on gastrointestinal function after laparoscopic cholecystectomy under general anesthesia.

METHODS

A total of 150 patients(American Society of Anesthesiologists[ASA] grades Ⅰ and Ⅱ) undergoing laparoscopic cholecystectomy in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Guangzhou University of Chinese Medicine were randomly assigned into three groups: electroacupuncture group (=50), simple acupuncture group (=50), and control group (=50). Patients in the control group received routine treatment;on the basis of routine treatment, patients in the simple acupuncture group were acupunctured at bilateral ST36, ST37 and SP36;patients in the electroacupuncture group were treated with electroacupuncture at bilateral ST36, ST37 and SP36(50 Hz,5 mA). In both simple acupuncture group and electroacupuncture group, the corresponding treatments were conducted 1 h after surgery, Patients as well as in the morning (8:00-10:00) and afternoon (14:00-16:00) on the first day after surgery, 30 min each time. The time of bowel sound recovery, the time to the first postope-rative exhaust and defecation, the time of postoperative fluid diet recovery, abdominal pain score, and gastrointestinal reaction score were recorded and analyzed.

RESULTS

Compared with the control group, the electroacupuncture group and the simple acupuncture group showed shortened time of bowel sound recovery, shortened time to the first postoperative exhaust and defecation, and shortened time of postoperative liquid diet recovery (<0.01), as well as decreased postoperative abdominal pain score and gastrointestinal reaction score (<0.01). Furthermore, the time of bowel sound recovery, the time to the first postoperative exhaust and defecation, and the time of postoperative liquid diet recovery were shortened in the electroacupuncture group compared with those in the simple acupuncture group (<0.01). The total effective rate of electroacupuncture group was 94.0% (47/50), the total effective rate of simple acupuncture group was 88.0% (44/50), significantly higher than 78.0% (39/50) in the control group (<0.05).

CONCLUSION

Both electroacupuncture and simple acupuncture can promote the recovery of gastrointestinal function in patients after laparoscopic cholecystectomy under general anesthesia, and electroacupuncture is superior to simple acupuncture,but they have no significant difference in alleviating postoperative abdominal pain and gastrointestinal reactions.

摘要

目的

观察电针双侧足三里(ST36)、上巨虚(ST37)及三阴交(SP6)穴位对全身麻醉下腹腔镜胆囊切除术后胃肠功能的影响。

方法

广州中医药大学第一附属医院肝胆外科150例接受腹腔镜胆囊切除术的患者(美国麻醉医师协会[ASA]分级为Ⅰ级和Ⅱ级)被随机分为三组:电针组(n = 50)、单纯针刺组(n = 50)和对照组(n = 50)。对照组患者接受常规治疗;单纯针刺组患者在常规治疗基础上,针刺双侧ST36、ST37及SP36;电针组患者采用50 Hz、5 mA的电流强度对双侧ST36、ST37及SP36进行电针治疗。单纯针刺组和电针组均在术后1 h开始进行相应治疗,于术后第1天上午(8:00 - 10:00)和下午(14:00 - 16:00)各治疗1次,每次30 min。记录并分析肠鸣音恢复时间、首次排气排便时间、术后流食恢复时间、腹痛评分及胃肠道反应评分。

结果

与对照组相比,电针组和单纯针刺组肠鸣音恢复时间、首次排气排便时间及术后流食恢复时间均缩短(P < 0.01),术后腹痛评分及胃肠道反应评分降低(P < 0.01)。此外,电针组肠鸣音恢复时间、首次排气排便时间及术后流食恢复时间较单纯针刺组缩短(P < 0.01)。电针组总有效率为94.0%(47/50),单纯针刺组总有效率为88.0%(44/50),显著高于对照组的78.0%(39/50)(P < 0.05)。

结论

电针和单纯针刺均可促进全身麻醉下腹腔镜胆囊切除术后患者胃肠功能的恢复,且电针优于单纯针刺,但二者在缓解术后腹痛及胃肠道反应方面无显著差异。

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