文章摘要
经皮穴位电刺激对盆底重建手术患者术后睡眠及恢复质量的影响
Effect of transcutaneous electrical acupoint stimulation on postoperative sleep and quality of recovery in patients undergoing pelvic floor reconstructive surgery
  
DOI：10.12089/jca.2026.03.007
中文关键词: 经皮穴位电刺激  中西医结合  加速术后康复  盆底重建手术  睡眠质量  恢复质量
英文关键词: Transcutaneous electrical acupoint stimulation  Integrated traditional Chinese and Western medicine  Enhanced recovery after surgery  Pelvic floor reconstructive surgery  Perioperative sleep  Quality of recovery
基金项目:重庆市科卫联合中医药科研项目（2023MSXM153）
作者单位E-mail
安民 401147,重庆市妇幼保健院（重庆医科大学附属妇女儿童医院）麻醉科,国家卫生健康委出生缺陷与生殖健康重点实验室  
雷晓峰 401147,重庆市妇幼保健院（重庆医科大学附属妇女儿童医院）麻醉科,国家卫生健康委出生缺陷与生殖健康重点实验室  
吴花 401147,重庆市妇幼保健院（重庆医科大学附属妇女儿童医院）麻醉科,国家卫生健康委出生缺陷与生殖健康重点实验室  
李静 401147,重庆市妇幼保健院（重庆医科大学附属妇女儿童医院）麻醉科,国家卫生健康委出生缺陷与生殖健康重点实验室  
赵娜 401147,重庆市妇幼保健院（重庆医科大学附属妇女儿童医院）麻醉科,国家卫生健康委出生缺陷与生殖健康重点实验室 13279421462@qq.com 
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中文摘要:
      
目的： 探讨经皮穴位电刺激（TEAS）对盆底重建手术患者术后睡眠及恢复质量的影响。
方法： 选择择期行盆底重建手术的中老年女性患者，年龄60～86岁，BMI 18.5～28.0 kg/m2，ASA Ⅱ或Ⅲ级。采用随机数字表法将患者分为两组：对照组（C组）和TEAS组（T组）。T组于术前第1晚、术后第1晚、第2晚、第3晚19：00给予TEAS（双侧神门穴、安眠穴、合谷穴及三阴交穴）。C组于相同时点给予穴位电极片但不进行电刺激。主要指标为术后第1晚理查兹-坎贝尔睡眠问卷（RCSQ）评分。次要指标包括术前第1晚、术后第1晚、第3晚、第5晚睡眠效率、深睡眠时间占比、快速眼动时间占比，术前第1晚、术后第3晚、第5晚RCSQ评分，术前匹兹堡睡眠质量指数（PSQI），术前第1晚、术后第1晚、第3晚血清肿瘤坏死因子-α（TNF-α）和褪黑素（MT）浓度，术后24、48 h VAS疼痛评分和补救镇痛率，术后第1天、第5天15项恢复质量（QoR-15）评分。不良反应包括术后恶心呕吐和头晕。
结果： 共纳入患者119例，C组59例，T组60例。与C组比较，T组术后第1晚、第3晚睡眠效率、深睡眠时间占比、快速眼动时间占比、RCSQ评分、入睡容易程度和睡眠质量评分明显升高，TNF-α浓度明显降低，MT浓度明显升高；术后第5晚睡眠效率、深睡眠时间占比、RCSQ评分和睡眠质量评分明显升高，术后24 h VAS疼痛评分明显降低，术后第1天QoR-15评分明显升高（P＜0.05）。两组术后不良反应发生率差异无统计学意义。
结论： TEAS有助于改善中老年患者盆底重建术后主客观睡眠质量，促进睡眠结构恢复并提升早期恢复质量，其潜在机制可能与疼痛减轻、减轻炎症反应降低及褪黑素节律维持有关。
英文摘要:
      
Objective: To investigate the effects of transcutaneous electrical acupoint stimulation (TEAS) on postoperative sleep and quality of recovery in patients undergoing pelvic floor reconstructive surgery.
Methods: Middle-aged and elderly female patients scheduled for elective pelvic floor reconstructive surgery, aged 60-86 years, BMI 18.5-28.0 kg/m2, ASA physical status Ⅱ or Ⅲ were selected. Patients were randomly divided into two groups: the control group (group C) and the TEAS group (group T). Group T received stimulation at bilateral Shenmen, Anmian, Hegu, and Sanyinjiao acupoints at 19∶00 on the night before surgery, on 1 night, 2, and 3 nights postoperatively. Group C received identical electrode placement without stimulation at the same time. The primary outcome was Richards-Campbell sleep questionnaire (RCSQ) score on 1 night postoperatively. Secondary outcomes included the sleep efficiency, the proportion of deep sleep, the proportion of rapid eye movement (REM) sleep on 1 night preoperatively, on 1 night, 3, and 5 nights postoperatively, and RCSQ score on 1 night preoperatively, on 3 and 5 nights postoperatively, preoperative Pittsburgh sleep quality index (PSQI), serum melatonin (MT) and tumor necrosis factor-alpha (TNF-α) levels on 1 night preoperatively,on 1 night and 3 nights postoperatively, VAS pain scores at 24 and 48 hours postoperatively and the incidence of rescue analgesia, the 15-item quality of recovery (QoR-15) scores on 1 day and 5 days postoperatively. Adverse reactions included nausea, vomiting, and dizziness.
Results: A total of 119 patients were included, 59 patients in group C and 60 patients in group T. Compared with group C, the sleep efficiency, deep sleep proportion, the proportion of REM sleep, RCSQ score, ease of falling asleep and sleep quality scoreswere significantly increased, the concentrations of TNF-α were significantly decreased, the concentrations of MT were significantly increased on 1 night and 3 nights postoperatively in group T (P < 0.05), the sleep efficiency, deep sleep proportion, RCSQ score, and sleep quality scoreswere significantly increased on 5 nights postoperatively, VAS pain score at 24 hours postoperatively was significantly decreased, and QoR-15 score on 1 day postoperatively was significantly increased in group T (P < 0.05). There were no significantly differences in the incidence of adverse events between the two groups.
Conclusion: TEAS may help improve both subjective and objective postoperative sleep quality, promote the restoration of sleep architecture, and enhance early quality of recovery in middle-aged and elderly patients undergoing pelvic floor reconstructive surgery. Its potential mechanisms may involve pain reduction, attenuation of inflammatory responses, and maintenance of melatonin rhythmicity.
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