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| 经皮穴位电刺激预处理对蛛网膜下腔阻滞肛肠手术后尿潴留的影响 |
| Effects of transcutaneous electrical acupoint stimulation preconditioning on postoperative urinary retention in patients receiving anorectal surgery in spinal anesthesia |
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| DOI：10.12089/jca.2023.02.006 |
| 中文关键词: 经皮穴位电刺激 预处理 术后尿潴留 蛛网膜下腔阻滞 肛肠手术 |
| 英文关键词: Transcutaneous electrical acupoint stimulation Preconditioning Postoperative urinary retention Spinal anesthesia Anorectal surgery |
| 基金项目: |
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| 中文摘要: |
目的 评价经皮穴位电刺激（TEAS）预处理对蛛网膜下腔阻滞（腰麻）肛肠手术后尿潴留的影响。
方法 选择择期在腰麻下行肛肠手术的患者195例，男122例，女73例，年龄18～64岁，BMI 18～28 kg/m2，ASA Ⅰ或Ⅱ级。采用随机数字表法将患者随机分为三组：腰麻前TEAS预处理组（A组）、手术结束时TEAS组（B组）和对照组（C组），每组65例。A组于腰麻前经皮电刺激中极穴（RN3）、气海穴（RN6）、关元穴（RN4）、关元俞穴（BL26）和八髎穴（BL31-34），疏密波频率2/100 Hz，电流强度6～10 mA，刺激时间30 min；B组于手术结束后立刻选取与A组相同的穴位、频率、刺激强度及刺激时间；C组不予电刺激。记录首次排尿时间、首次排尿量、首次排尿等待时间以及术后当晚小腹胀满感评分以及术后尿潴留和术后因尿潴留导尿情况。
结果 与A组比较，B组首次排尿量明显减少（P＜0.05）；C组首次排尿时间、首次排尿等待时间明显延长，首次排尿量明显减少，术后当晚小腹胀满感评分明显升高（P＜0.05）。与B组比较，C组首次排尿时间明显延长（P＜0.05）。与A组比较，B组和C组术后尿潴留发生率明显升高（P＜0.05），C组因尿潴留导尿率明显升高（P＜0.05）。
结论 腰麻前给予经皮穴位电刺激预处理可明显降低肛肠手术后尿潴留的发生率，能更好地保护膀胱功能，促进排尿功能的恢复。 |
| 英文摘要: |
Objective To evaluate the effect of precondition with transcutaneous electrical acupoint stimulation (TEAS) on postoperative urinary retention in patients receiving anorectal surgery in spinal anesthesia.
Methods A total of 195 patients undergoing elective anorectal surgery in spinal anesthesia, 122 males and 73 females, aged 18-64 years, BMI 18-28 kg/m2, ASA physical status Ⅰ or Ⅱ, were randomly divided into three groups: precondition group with TEAS before spinal anesthesia (group A), TEAS group at the end of surgery (group B) and control group (group C), 65 patients in each group. Group A received TEAS at Zhongji (RN3), Qihai (RN6), Guanyuan (RN4), Guanyuanshu (BL26) and Baliao (BL31-34) points before spinal anesthesia, in a frequency of 2/100 Hz, in the from of dilatational wave, current intensity of 6-10 mA, and lasting 30 minutes of stimulation. The same points, frequency, stimulation intensity, and stimulation time as group A were selected immediately at the end of the surgery in group B. Group C received no electrical stimulation. The time of first urination, the volume of first urination, the waiting time for the first urination, and the score of fullness of lower abdomen on the night after surgery were recorded. Postoperative urinary retention and catheterization due to postoperative urinary retention were recorded.
Results Compared with group A, the first urination volume in group B was significantly reduced (P < 0.05), the first urination time and waiting time for the first urination were significantly prolonged, the first urination volume was significantly reduced, and the score of fullness of lower abdomen on the night after surgery was significantly increased in group C (P < 0.05). Compared with group B, the first urination time was significantly longer in group C (P < 0.05). Compared with group A, the incidence of postoperative urinary retention was significantly increased in groups B and C (P < 0.05), and the catheterization rate due to postoperative urinary retention was significantly increased in group C (P < 0.05).
Conclusion Precondition with transcutaneous electrical acupoint stimulation before spinal anesthesia can significantly reduce the incidence of urinary retention after anorectal surgery, which is beneficial for the protection of bladder function and the recovery of urination function. |
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