Department of Chinese Medicine Chi Mei Medical Center, Tainan.
Department of Anesthesiology, Chi Mei Medical Center, Tainan.
Int J Surg. 2024 Feb 1;110(2):1113-1125. doi: 10.1097/JS9.0000000000000848.
This meta-analysis aimed to evaluate the efficacy and safety of electroacupuncture (EA) in improving postoperative ileus after colorectal surgery.
Electronic databases (e.g. Medline) were screened to identify randomized controlled trials that focused on the association between EA and postoperative ileus. Time to first flatus served as the primary outcome, while the secondary outcomes included time required for the recovery of other gastrointestinal functions (e.g. bowel sound recovery), time to tolerability of liquid/solid food, postoperative pain scores, risk of overall complications, and hospital length of stay.
Our meta-analysis focusing on 16 studies with a total of 1562 patients demonstrated positive associations of EA with shorter times to the first flatus [mean difference (MD): -10.1 h, P <0.00001, n =1562], first defecation (MD: -11.77 h, P <0.00001, n =1231), bowel sound recovery (MD: -10.76 h, P <0.00001, n =670), tolerability of liquid (MD: -16.44 h, P =0.0002, n =243), and solid food (MD: -17.21 h, P =0.005, n =582) than those who received standard care. The use of EA was also correlated with a lower risk of overall complications (risk ratio:0.71, P =0.04, n =1011), shorter hospital length of stay (MD: -1.22 days, P =0.0001, n =988), and a lower pain score on postoperative days two (standardized MD: -0.87, P =0.009, n =665) and three (standardized MD: -0.45, P <0.00001, n =795), without a difference in time to first ambulation.
Our findings showed an association between EA and enhanced gastrointestinal functional recovery and reduced pain severity following colorectal surgery, highlighting the potential benefits of incorporating EA into perioperative care to enhance recovery outcomes in this setting.
本荟萃分析旨在评估电针(EA)在改善结直肠手术后肠麻痹方面的疗效和安全性。
电子数据库(如 Medline)进行筛选,以确定专注于 EA 与术后肠麻痹之间关联的随机对照试验。首次排气时间为主要结局,而次要结局包括其他胃肠功能恢复所需的时间(例如肠鸣音恢复)、液体/固体食物耐受时间、术后疼痛评分、总体并发症风险和住院时间。
我们的荟萃分析重点关注了 16 项研究,共有 1562 名患者,结果表明 EA 与首次排气时间更短之间存在正相关关系[平均差异(MD):-10.1 小时,P<0.00001,n=1562]、首次排便(MD:-11.77 小时,P<0.00001,n=1231)、肠鸣音恢复(MD:-10.76 小时,P<0.00001,n=670)、液体耐受(MD:-16.44 小时,P=0.0002,n=243)和固体食物(MD:-17.21 小时,P=0.005,n=582),而不是接受标准护理的患者。使用 EA 还与总体并发症风险降低相关(风险比:0.71,P=0.04,n=1011)、住院时间缩短(MD:-1.22 天,P=0.0001,n=988)和术后第 2 天(标准化 MD:-0.87,P=0.009,n=665)和第 3 天(标准化 MD:-0.45,P<0.00001,n=795)的疼痛评分降低,而首次步行时间无差异。
我们的研究结果表明,EA 与结直肠手术后胃肠道功能恢复加快和疼痛严重程度降低之间存在关联,这突出了在围手术期护理中纳入 EA 以增强该环境下的恢复结局的潜在益处。