Zhang Meng, Zhao Nan, He Jin-Hua, Li Jian-Li
Department of Anesthesia, Hebei People's Hospital, Shijiazhuang 050051, China.
Department of Anesthesia, Third Hospital of Hebei Medical University.
Zhongguo Zhen Jiu. 2023 Jul 12;43(7):751-5. doi: 10.13703/j.0255-2930.20220919-k0002.
To observe the effects of transcutaneous acupoint stimulation (TEAS) on sleep quality and inflammatory factor in frail elderly patients undergoing laparoscopic colorectal cancer surgery.
A total of 100 frail elderly patients undergoing elective laparoscopic colorectal cancer surgery were randomly divided into an observation group and a control group, 50 cases in each one. Patients in the observation group received TEAS, 30 min before surgery until the end of surgery, at 18:00 on the day of surgery and on the 1st, 2nd and 3rd day after surgery (30 min each time). TEAS was delivered at bilateral Neiguan (PC 6), Shenmen (HT 7) and Hegu (LI 4). The disperse-dense wave of 2 Hz/100 Hz was selected, and the maximal stimulation intensity depended on patient's tolerance. The operation procedure in the control group was same as the observation group, but without electric stimulation exerted. The 1st day before surgery and on the 1st, 3rd and 7th day after surgery, the scores of Pittsburgh sleep quality index (PSQI) and Athens insomnia scale (AIS), as well as the serum levels of C reactive protein (CRP) and interleukin-6 (IL-6) were observed in the patients of two groups. At 24 h, 48 h and 72 h after surgery, the score of pain visual analogue scale (VAS) was recorded in the two groups, as well as the pressing times of analgesic pump and the usage of flurbiprofen axetil during analgesic stage. The occurrence of post operative adverse reactions was observed in the patients of two groups.
On the 1st and 3rd day after surgery, except the usage of hypnotic drug scores, the scores of each item and the total scores of PSQI, as well as AIS scores were all increased in the two groups compared with those of 1 day before surgery (<0.05) and the scores in the observation group were lower than those in the control group (<0.05). On the 7th day after surgery, the scores of each item and the total scores of PSQI, and AIS scores were not different statistically in comparison between the two groups (>0.05). On the 1st, 3rd and 7th day after surgery, serum levels of CRP and IL-6 were all increased in the patients of two groups when compared with those of 1 day before surgery (<0.05), serum levels CRP and IL-6 in the patients of the observation group were lower than those of the control group (<0.05). The VAS scores of 24 h, 48 h and 72 h after surgery, the pressing times of analgesic pump, the frequency and dosage of the remedies were not different statistically between the two groups (>0.05).
TEAS can effectively improve sleep quality and reduce inflammatory reaction in frail elderly patients undergoing laparoscopic colorectal cancer surgery.
观察经皮穴位电刺激(TEAS)对接受腹腔镜结直肠癌手术的体弱老年患者睡眠质量和炎症因子的影响。
选取100例择期行腹腔镜结直肠癌手术的体弱老年患者,随机分为观察组和对照组,每组50例。观察组患者于手术前30分钟至手术结束、手术当天18:00以及术后第1、2、3天接受TEAS治疗(每次30分钟)。刺激双侧内关(PC 6)、神门(HT 7)和合谷(LI 4)。选择2Hz/100Hz疏密波,最大刺激强度依患者耐受程度而定。对照组手术操作与观察组相同,但不施加电刺激。观察两组患者手术前1天及术后第1、3、7天的匹兹堡睡眠质量指数(PSQI)和雅典失眠量表(AIS)评分,以及血清C反应蛋白(CRP)和白细胞介素-6(IL-6)水平。记录两组患者术后24小时、48小时和72小时的疼痛视觉模拟评分(VAS),以及镇痛泵按压次数和镇痛阶段氟比洛芬酯的使用情况。观察两组患者术后不良反应的发生情况。
术后第1天和第3天,与术前1天相比,两组患者PSQI各项目评分、总分及AIS评分均升高(<0.05),且观察组低于对照组(<0.05)。术后第7天,两组患者PSQI各项目评分、总分及AIS评分差异无统计学意义(>0.05)。术后第1天、第3天和第7天,两组患者血清CRP和IL-6水平均高于术前1天(<0.05),观察组患者血清CRP和IL-6水平低于对照组(<0.05)。两组患者术后24小时、48小时和72小时的VAS评分、镇痛泵按压次数、补救措施的频率和剂量差异无统计学意义(>0.05)。
TEAS可有效改善接受腹腔镜结直肠癌手术的体弱老年患者的睡眠质量,减轻炎症反应。