Zhang Yan-Fang, Li Xiang-Yun, Liu Xiu-Yun, Zhang Yuan, Gong Li-Rong, Shi Jia, Du Shi-Han, He Si-Meng, Li Cui, Li Yu-Ting, Li Na, Liu Sha-Sha, Wu Ya, Xie Zi-Lei, Pei Zheng-Cun, Yu Jian-Bo
Department of Anesthesiology and Critical Care Medicine, Tianjin Nankai Hospital, Tianjin Medical University, 6 Changjiang Road, Tianjin, People's Republic of China.
Department of Biomedical Engineering, College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China.
World J Surg. 2023 May;47(5):1153-1162. doi: 10.1007/s00268-023-06924-7. Epub 2023 Feb 6.
Facilitating the recurrence of spontaneous voiding is considered to be a way to prevent urinary retention after surgery, which is of great importance in cholecystectomy. This study aimed to assess the effect of transcutaneous electrical acupoint stimulation (TEAS) on spontaneous voiding recovery after laparoscopic cholecystectom.
Participants who underwent elective laparoscopic cholecystectomy were randomly assigned to either the TEAS group or the sham group. Active TEAS or sham TEAS at specific acupuncture points was conducted intraoperatively and postoperatively. The primary outcome was the recovery speed of spontaneous voiding ability after surgery and secondary outcomes included postoperative urinary retention (POUR), voiding dysfunction, pain, anxiety and depression, and early recovery after surgery.
A total of 1,948 participants were recruited and randomized to TEAS (n = 975) or sham (n = 973) between August 2018 and June 2020. TEAS shortens the time delay of the first spontaneous voiding after laparoscopic cholecystectomy (5.6 h [IQR, 3.7-8.1 h] in the TEAS group vs 7.0 h [IQR, 4.7-9.7 h] in the sham group) (p < 0.001). The TEAS group experienced less POUR (p = 0.020), less voiding difficulty (p < 0.001), less anxiety and depression (p < 0.001), reduced pain (p = 0.007), and earlier ambulation (p = 0.01) than the sham group.
Our results showed that TEAS is an effective approach to accelerate the recovery of spontaneous voiding and reduce POUR which facilitates recovery for patients after laparoscopic cholecystectomy.
促进自主排尿恢复被认为是预防手术后尿潴留的一种方法，这在胆囊切除术中非常重要。本研究旨在评估经皮穴位电刺激（TEAS）对腹腔镜胆囊切除术后自主排尿恢复的影响。
接受择期腹腔镜胆囊切除术的参与者被随机分配到TEAS组或假手术组。在手术中和术后对特定穴位进行主动TEAS或假TEAS。主要结局是术后自主排尿能力的恢复速度，次要结局包括术后尿潴留（POUR）、排尿功能障碍、疼痛、焦虑和抑郁以及术后早期恢复情况。
2018年8月至2020年6月期间，共招募了1948名参与者并将其随机分为TEAS组（n = 975）或假手术组（n = 973）。TEAS缩短了腹腔镜胆囊切除术后首次自主排尿的时间延迟（TEAS组为5.6小时[四分位间距，3.7 - 8.1小时]，假手术组为7.0小时[四分位间距，4.7 - 9.7小时]）（p < 0.001）。与假手术组相比，TEAS组的POUR更少（p = 0.020）、排尿困难更少（p < 0.001）、焦虑和抑郁更少（p < 0.001）、疼痛减轻（p = 0.007）且更早下床活动（p = 0.01）。
我们的结果表明，TEAS是一种有效的方法，可加速自主排尿恢复并减少POUR，这有助于腹腔镜胆囊切除术后患者的恢复。
