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经皮神经电刺激疗法在降低剖宫产术后切口感染发生率中的作用。

The role of TENS therapy in reducing the incidence of post-Caesarean section wound infection.

机构信息

Reproductive Medicine Center, The Central Hospital of Enshi Prefecture Tujia and Miao Autonomous Prefecture, China.

Department of Gynaecology and Obstetrics, The Central Hospital of Enshi Prefecture Tujia and Miao Autonomous Prefecture, Hubei, China.

出版信息

Int Wound J. 2024 Jul;21(7):e70001. doi: 10.1111/iwj.70001.

Abstract

The occurrence of wound infection following a Caesarean section procedure poses a substantial clinical obstacle. Transcutaneous Electrical Nerve Stimulation (TENS) has been identified as a promising supplementary treatment option for improving the healing process and decreasing the incidence of infections. This study assessed the efficacy of TENS therapy in the postoperative care of patients who have had Caesarean section. We randomly assigned a total of 108 women who had Caesarean sections to either a TENS group (n = 54) or control (n = 54). The TENS therapy was provided twice daily for a duration of 30 min for the period of 14 days following the surgery. The main measure of interest in this study was the occurrence of wound infection during 30-day period. Additionally, secondary measures included the rate of wound healing, levels of pain experienced and level of patient satisfaction. In comparison to the control (22.2%, p < 0.05), the TENS group had notably reduced occurrence of wound infection, with the rate of 7.4%. TENS group had superior wound healing results, as measured by REEDA scale, at 7 days (2.1 ± 0.8 vs. 2.5 ± 1.0, p < 0.04), 14 days (1.2 ± 0.5 vs. 1.9 ± 0.7, p < 0.05) and 30 days (0.3 ± 0.5 vs. 0.7 ± 0.6, p < 0.05). Furthermore, TENS group had reduced pain levels on the Visual Analog Scale (VAS) at all evaluation intervals (p < 0.05). TENS group exhibited significantly higher levels of patient satisfaction, as evidenced by 64.8% of participants rating high satisfaction, in contrast to 40.7% in the control group (p < 0.05). The incidence of adverse effects was found to be minor, as indicated by a skin irritation rate of 3.7% and reported discomfort rate of 1.9% at the electrode location. TENS therapy effectively decreased the occurrence of post-Caesarean wound infections, expedited the healing process and enhanced pain control. This treatment was well-received by patients and had little negative consequences. The aforementioned results provided evidence in favour of incorporating TENS into post-Caesarean care regimens, which may have significant consequences for improving patient outcomes and maximizing healthcare resources.

摘要

剖宫产术后发生伤口感染是一个严重的临床障碍。经皮神经电刺激(TENS)已被确定为一种有前途的辅助治疗选择,可以改善愈合过程并降低感染发生率。本研究评估了 TENS 疗法在剖宫产术后患者中的应用效果。我们将 108 名接受剖宫产术的女性随机分为 TENS 组(n=54)和对照组(n=54)。TENS 治疗每天进行两次,持续 30 分钟,共 14 天。本研究的主要观察指标是 30 天内伤口感染的发生情况。此外,次要观察指标包括伤口愈合率、疼痛程度和患者满意度。与对照组(22.2%,p<0.05)相比,TENS 组的伤口感染发生率明显降低,为 7.4%。TENS 组在 REEDA 量表上的伤口愈合结果也更好,第 7 天(2.1±0.8 比 2.5±1.0,p<0.04)、第 14 天(1.2±0.5 比 1.9±0.7,p<0.05)和第 30 天(0.3±0.5 比 0.7±0.6,p<0.05)。此外,TENS 组在所有评估时间点的视觉模拟评分(VAS)上的疼痛水平均较低(p<0.05)。TENS 组的患者满意度显著更高,64.8%的参与者表示非常满意,而对照组为 40.7%(p<0.05)。不良事件发生率较低,皮肤刺激率为 3.7%,电极部位不适发生率为 1.9%。TENS 治疗有效降低了剖宫产术后伤口感染的发生率,加快了愈合过程,增强了疼痛控制。这种治疗方法受到了患者的欢迎,且几乎没有不良后果。上述结果支持将 TENS 纳入剖宫产术后护理方案,这可能对改善患者结局和最大化医疗资源利用具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c169/11263808/d819d74c8f10/IWJ-21-e70001-g002.jpg

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