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按压式进针刺激对电视胸腔镜手术患者术后肺部并发症的影响:一项随机对照试验

Effect of press needle stimulation on postoperative pulmonary complications in video-assisted thoracoscopic surgery patients: a randomized controlled trial.

作者信息

Tan Jing, Feng Yong, Liu Hui, Zhou Yihu, Cai Jiaqin, Jiang Yueyi, Li Pengyi, Gu Lianbing, Song Zhenghuan

机构信息

Department of Anesthesiology, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, People's Republic of China.

Department of Radiology, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, People's Republic of China.

出版信息

Ann Med. 2025 Dec;57(1):2560684. doi: 10.1080/07853890.2025.2560684. Epub 2025 Sep 15.

Abstract

BACKGROUND

Patients undergoing high-risk surgical procedures frequently experience postoperative pulmonary complications (PPCs) that impact outcomes. Acupuncture has demonstrated potential benefits during surgery. Press needle stimulation is increasingly recognized as an alternative to conventional techniques. We aimed to evaluate the effect of press needle stimulation on PPCs in patients with lung cancer undergoing video-assisted thoracoscopic surgery.

METHODS

Eighty-seven patients undergoing video-assisted thoracoscopic surgery were randomized into press needle ( = 48) or sham needle ( = 39) groups. The press needle group underwent bilateral stimulation of acupoints LU9 (Taiyuan), RN17 (Danzhong), LU6 (Kongzui), and BL13 (Feishu) before anesthesia and during surgery. The sham group received a placebo stimulation. The primary endpoint was the incidence of PPCs within seven days post-surgery. The secondary endpoints included cytokine levels, intraoperative respiratory mechanics, postoperative pain score, analgesic consumption, and related complications.

RESULTS

Press needle acupoint stimulation was associated with a significantly lower incidence of PPCs than the sham needle group. Perioperative data, tachycardia, cough, postoperative nausea, vomiting, and most inflammatory markers exhibited no significant differences, except for lower hypoxia-inducible factor-1 levels in the press needle group. Hemodynamic and blood gas analyses indicated no significant cardiovascular or respiratory differences between groups. The press needle group exhibited reduced patient-controlled analgesia (PCA) pump utilization and lower total PCA usage, indicating improved pain management.

CONCLUSION

This study indicates that press needle stimulation lowers PPC incidence and improves postoperative analgesia in patients with lung cancer undergoing video-assisted thoracoscopic lobectomy.

摘要

背景

接受高风险外科手术的患者经常会出现影响手术结果的术后肺部并发症(PPCs)。针灸已在手术过程中显示出潜在益处。揿针刺激越来越被认为是传统技术的一种替代方法。我们旨在评估揿针刺激对接受电视辅助胸腔镜手术的肺癌患者术后肺部并发症的影响。

方法

87例接受电视辅助胸腔镜手术的患者被随机分为揿针组(n = 48)和假针组(n = 39)。揿针组在麻醉前和手术期间对双侧穴位肺俞9(太渊)、膻中(膻中)、肺俞6(孔最)和膀胱经13(肺俞)进行刺激。假针组接受安慰剂刺激。主要终点是术后7天内术后肺部并发症的发生率。次要终点包括细胞因子水平、术中呼吸力学、术后疼痛评分、镇痛药物消耗量及相关并发症。

结果

与假针组相比揿针穴位刺激术后肺部并发症的发生率显著降低。围手术期数据、心动过速、咳嗽、术后恶心、呕吐以及大多数炎症标志物均无显著差异,只是揿针组的低氧诱导因子-1水平较低。血流动力学和血气分析表明两组之间在心血管或呼吸方面无显著差异。揿针组患者自控镇痛(PCA)泵的使用减少,PCA总用量较低,表明疼痛管理得到改善。

结论

本研究表明,揿针刺激可降低接受电视辅助胸腔镜肺叶切除术的肺癌患者术后肺部并发症的发生率,并改善术后镇痛效果。

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