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接受胃切除术/结肠切除术的成年患者的经皮穴位电刺激:一项随机对照试验。

Transcutaneous electrical acupoint stimulation in adult patients receiving gastrectomy/colorectal resection: A randomized controlled trial.

作者信息

Hou Yuan-Tao, Pan Yuan-Yuan, Wan Lei, Zhao Wen-Sheng, Luo Ying, Yan Qi, Zhang Yi, Zhang Wei-Xin, Mo Yun-Chang, Huang Lu-Ping, Dai Qin-Xue, Jia Dan-Yun, Yang Ai-Ming, An Hai-Yan, Wu An-Shi, Tian Ming, Fang Jian-Qiao, Wang Jun-Lu, Feng Yi

机构信息

Department of Anesthesiology, Peking University People's Hospital, Beijing 100044, China.

Department of Anesthesiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.

出版信息

World J Gastrointest Surg. 2023 Jul 27;15(7):1474-1484. doi: 10.4240/wjgs.v15.i7.1474.

Abstract

BACKGROUND

Acupuncture promotes the recovery of gastrointestinal function and provides analgesia after major abdominal surgery. The effects of transcutaneous electrical acupoint stimulation (TEAS) remain unclear.

AIM

To explore the potential effects of TEAS on the recovery of gastrointestinal function after gastrectomy and colorectal resection.

METHODS

Patients scheduled for gastrectomy or colorectal resection were randomized at a 2:3:3:2 ratio to receive: (1) TEAS at maximum tolerable current for 30 min immediately prior to anesthesia induction and for the entire duration of surgery, plus two 30-min daily sessions for 3 consecutive days after surgery (perioperative TEAS group); (2) Preoperative and intraoperative TEAS only; (3) Preoperative and postoperative TEAS only; or (4) Sham stimulation. The primary outcome was the time from the end of surgery to the first bowel sound.

RESULTS

In total, 441 patients were randomized; 405 patients (58.4 ± 10.2 years of age; 247 males) received the planned surgery. The time to the first bowel sounds did not differ among the four groups ( = 0.90; log-rank test). On postoperative day 1, the rest pain scores differed significantly among the four groups ( = 0.04; Kruskal-Wallis test). Post hoc comparison using the Bonferroni test showed lower pain scores in the perioperative TEAS group (1.4 ± 1.2) than in the sham stimulation group (1.7 ± 1.1; = 0.04). Surgical complications did not differ among the four groups.

CONCLUSION

TEAS provided analgesic effects in adult patients undergoing major abdominal surgery, and it can be added to clinical practice as a means of accelerating postoperative rehabilitation of these patients.

摘要

背景

针刺可促进腹部大手术后胃肠功能恢复并提供镇痛作用。经皮穴位电刺激(TEAS)的效果尚不清楚。

目的

探讨TEAS对胃癌根治术和结直肠癌切除术后胃肠功能恢复的潜在影响。

方法

计划行胃癌根治术或结直肠癌切除术的患者按2:3:3:2的比例随机分组,分别接受:(1)在麻醉诱导前立即给予最大耐受电流的TEAS 30分钟,并在手术全程给予,术后连续3天每天进行2次30分钟的TEAS(围手术期TEAS组);(2)仅术前和术中进行TEAS;(3)仅术前和术后进行TEAS;或(4)假刺激。主要结局是从手术结束到首次肠鸣音出现的时间。

结果

总共441例患者被随机分组;405例患者(年龄58.4±10.2岁;男性247例)接受了计划的手术。四组患者首次肠鸣音出现的时间无差异(=0.90;对数秩检验)。术后第1天,四组患者的静息疼痛评分有显著差异(=0.04;Kruskal-Wallis检验)。使用Bonferroni检验进行的事后比较显示,围手术期TEAS组的疼痛评分(1.4±1.2)低于假刺激组(1.7±1.1;=0.04)。四组患者的手术并发症无差异。

结论

TEAS对接受腹部大手术的成年患者有镇痛作用,可作为加速这些患者术后康复的一种手段应用于临床实践。

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