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| 经皮穴位电刺激联合帕洛诺司琼对腹腔镜非胃肠手术患者术后早期恢复质量的影响 |
| Effect of transcutaneous electrical acupoint stimulation and palonosetron on early postoperative quality of recovery in patients undergoing laparoscopic non-gastrointestinal surgery |
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| DOI：10.12089/jca.2023.08.002 |
| 中文关键词: 经皮穴位电刺激 术后恶心呕吐 术后恢复质量 帕洛诺司琼 |
| 英文关键词: Transcutaneous electrical acupoint stimulation Postoperative nausea and vomiting Postoperative quality of recovery Palonosetron |
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| 中文摘要: |
目的 探讨经皮穴位电刺激（TEAS）联合帕洛诺司琼对腹腔镜非胃肠手术患者术后恶心呕吐和早期恢复质量的影响。
方法 选择择期全麻下行腹腔镜非胃肠手术患者648例，男28例，女620例，年龄18～50岁，BMI 15～40 kg/m2，ASA Ⅰ—Ⅲ级。采用随机数字表法将患者分为两组：TEAS组（T组，n=330）和对照组（C组，n=318）。两组患者均在麻醉诱导时预防性使用地塞米松和帕洛诺司琼，T组于麻醉苏醒后和术后第1天上午TEAS双侧内关穴和足三里穴，持续30 min；C组穴位选择同T组，患者连接电针刺激仪，但不给予通电刺激。记录术后24 h内恶心呕吐发生情况、40项恢复质量评分（QoR-40）、止吐补救和术后并发症发生情况。
结果 与C组比较，T组术后24 h内恶心、持续恶心、呕吐和呕吐累积发生率、恶心和呕吐最高VAS评分、止吐补救率和术后并发症发生率均明显降低（P＜0.05），QoR-40总评分、身体舒适、情绪状态、心理支持、身体独立和疼痛评分均明显升高（P＜0.05）。
结论 术后TEAS双侧内关穴和足三里穴联合帕洛诺司琼可降低腹腔镜非胃肠手术患者PONV和术后并发症发生率，提高术后早期恢复质量。 |
| 英文摘要: |
Objective To explore the effect of transcutaneous electrical acupoint stimulation (TEAS) and palonosetron on postoperative nausea and vomiting, as well as early postoperative quality of recovery in patients undergoing laparoscopic non-gastrointestinal surgery.
Methods A total of 648 patients undergoing laparoscopic non-gastrointestinal surgery, aged 18-50 years, BMI 15-40 kg/m2, ASA physical status Ⅰ-Ⅲ, were randomly divided into two groups using random number table method: TEAS group (group T, n = 330) and control group (group C, n = 318). Both groups received dexamethasone 5 mg (before induction) combined with palonosetron 0.075 mg (before induction). Group T was given TEAS at bilateral Neiguan point and Zusanli point twice at recovery from anesthesia and in the following morning for 30 minutes after operation, and group C was received identical settings, manipulation and acupoints to the group T, except that no current was delivered. The postoperative nausea and vomiting (PONV) incidence and severity, QoR-40 scores, antiemetic remediation rate, and postoperative complications within 24 hours after operation were recorded.
Results Compared with group C, the incidence of nausea, persistent nausea, vomiting, accumulation of vomiting, highest VAS score of nausea and vomiting, antiemetic remediation rate and incidence of postoperative complications within 24 hours after operation in group T were significantly decreased (P < 0.05). The total score of QoR-40, the scores of physical comfort, emotional state, psychological support, physical independence and pain 24 hours after operation in group T were significantly increased (P < 0.05).
Conclusion Postoperative TEAS at bilateral Neiguan point and Zusanli point in conjunction with palonosetron can reduce the incidence of PONV and postoperative complications, improve the early postoperative quality of recovery. |
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