Comprehensive Internal Medicine Department of Zhijiang Campus, Tongde Hospital of Zhejiang Province, Hangzhou, China.
Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou, China.
PLoS One. 2024 Oct 21;19(10):e0309673. doi: 10.1371/journal.pone.0309673. eCollection 2024.
We aim to evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation(TEAS) in elderly patients around the perioperative period of hip replacement surgery.
The China National Knowledge Infrastructure(CNKI), Wangfang Data, VIP database, SinoMed, PubMed, and Embase databases were searched for relevant publications until August 2024. All randomized controlled studies evaluating the efficacy and safety of TEAS in patients around the perioperative period of hip replacement surgery. We calculated pooled risk ratio (RR) with 95% CIs for binary outcomes and standardized mean difference (SMD) for continuous outcomes. The Cochrane's Risk of Bias Tool were used to evaluate the quality of studies.
A total of 13 studies with 946 patients were included in this analysis. 1-day visual analogue scale (VAS) scores and 2-day VAS scores were significantly lower in the TEAS group compared to the control group (SMD: -0.78, 95% CI: -1.47, -0.09, P = 0.02 and SMD:-0.54, 95% CI:-1.00,-0.09,P = 0.02). Furthermore, 1-day mini-mental state examination (MMSE) scores and 3-day MMSE scores were significantly higher in the TEAS group compared to the control group (SMD: 1.60, 95% CI: 0.68, 2.51,P<0.001 and SMD:1.31, 95% CI:1.03,1.59,P<0.001), along with a lower postoperative cognitive dysfunction rate (RR: 0.55, 95% CI: 0.41, 0.73, P<0.001).
Our meta-analysis demonstrated that TEAS significantly reduces pain and improves cognitive function in patients undergoing hip replacement surgery. Future studies should further investigate the optimal TEAS protocols to maximize these benefits across different population and surgical settings.
本研究旨在评估经皮穴位电刺激（TEAS）在老年髋关节置换围手术期的疗效和安全性。
检索中国知网（CNKI）、万方数据、维普数据库、中国生物医学文献数据库、PubMed 和 Embase 数据库，检索时间截至 2024 年 8 月，收集所有评估 TEAS 在髋关节置换围手术期患者中的疗效和安全性的随机对照研究。采用风险比（RR）和标准化均数差（SMD）作为效应指标，对二分类资料和连续性资料进行合并分析。采用 Cochrane 偏倚风险评估工具对纳入研究进行质量评价。
共纳入 13 项研究，946 例患者。TEAS 组患者术后 1 天和 2 天的视觉模拟评分（VAS）均低于对照组（SMD：-0.78，95%CI：-1.47，-0.09，P=0.02；SMD：-0.54，95%CI：-1.00，-0.09，P=0.02）。TEAS 组患者术后 1 天和 3 天的简易智力状态检查量表（MMSE）评分均高于对照组（SMD：1.60，95%CI：0.68，2.51，P<0.001；SMD：1.31，95%CI：1.03，1.59，P<0.001），术后认知功能障碍发生率低于对照组（RR：0.55，95%CI：0.41，0.73，P<0.001）。
该荟萃分析表明，TEAS 可显著减轻髋关节置换术患者的疼痛，改善认知功能。未来的研究应进一步探讨最佳的 TEAS 方案，以在不同人群和手术环境中最大限度地发挥这些益处。
