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| 经皮穴位电刺激对老年患者胸腔镜手术中低体温的影响 |
| Effect of transcutaneous electrical acupoint stimulation on intraoperative hypothermia in elderly patients undergoing thoracoscopic pneumonectomy |
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| DOI：10.12089/jca.2026.07.009 |
| 中文关键词: 老年 经皮穴位电刺激 低体温 胸腔镜手术 中西医结合 |
| 英文关键词: Aged Transcutaneous electrical acupoint stimulation Hypothermia Thoracoscopic pneumonectomy Integrated traditional Chinese and Western medicine |
| 基金项目:北京市通州区科技计划项目（KJ2024CX056） |
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| 中文摘要: |
目的：探讨经皮穴位电刺激（TEAS）对老年患者胸腔镜手术中低体温的影响。
方法：选择择期行胸腔镜手术的老年患者，年龄65～78岁，ASA Ⅱ或Ⅲ级。采用随机数字表法分为两组：TEAS组和对照组。TEAS组采用经皮穴位电刺激仪从麻醉诱导前30 min开始至手术结束持续刺激大椎穴、命门穴、关元穴和涌泉穴。对照组在相同穴位粘贴电极片但不进行电刺激。主要指标为术中低体温发生率。次要指标包括入手术室、诱导后即刻、诱导后30、60 min、术毕时体温、HR和MAP，苏醒时间、拔管时间和住院时间。不良反应包括术中窦性心动过缓、低血压、术后寒战、切口感染和房颤等。
结果：共纳入患者120例，每组60例。与对照组比较，TEAS组术中低体温发生率明显降低（18% vs. 45%），术后寒战发生率明显降低 （P<0.05）。两组术中HR、MAP、苏醒时间、拔管时间、住院时间、切口感染、房颤发生率差异无统计学意义。
结论：TEAS有助于降低老年患者胸腔镜手术中低体温发生，减少术后并发症，提高术后恢复质量。 |
| 英文摘要: |
Objective: To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) on intraoperative hypothermia in elderly patients undergoing thoracoscopic pneumonectomy.
Methods: Elderly patients scheduled for elective thoracoscopic pneumonectomy, aged 65-78 years, ASA physical status Ⅱ or Ⅲ were selected. Patients were randomly divided into two groups: the TEAS group and the control group.In the TEAS group, stimulation was applied at the acupoints Dazhui, Mingmen, Guanyuan, and Yongquan, starting 30 minutes before anesthesia induction and continuing until the end of the procedure. The control group received identical electrode placement without stimulation. The primary outcome was the incidence of intraoperative hypothermia. Secondary outcomes included body core temperature, HR and MAP at the time of entering the operating room, immediately after anesthesia induction, 30 and 60 minutes after induction, as well as at the end of surgery. Additional secondary outcomes covered the awakening time, the extubation time, and the length of hospital stay. Adverse reactions included intraoperative sinus bradycardia, hypotension, postoperative shivering, surgical site infection, and atrial fibrillation.
Results: A total of 120 patients were included, with 60 patients in each group. Compared with the control group, the incidence of intraoperative hypothermia was significantly lower in the TEAS group (18% vs. 45%), and the incidence of postoperative shivering was also markedly reduced (P < 0.05). There were no significant differences between the two groups in HR, MAP, the awakening time, the extubation time, the length of hospital stay, or the incidence of surgical site infection and atrial fibrillation.
Conclusion: TEAS may help reduce the incidence of intraoperative hypothermia and postoperative complications in elderly patients undergoing thoracoscopic pneumonectomy. |
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