经皮穴位电刺激促进妇科腹腔镜手术患者术后胃肠道功能恢复的meta分析

Transcutaneous electrical acupoint stimulation promoting the recovery of gastrointestinal function after gynecological laparoscopy:a meta-analysis

目的应用meta分析方法评价经皮穴位电刺激(TEAS)在促进妇科腹腔镜手术患者术后胃肠道功能恢复的有效性。方法系统检索PubMed、Cochrane Library RCT资料库(CCRCT)、Web of Science、Embase、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普(VIP)及万方(Wanfang)数据库,时间从建库至2022年7月,搜集所有关于TEAS用于妇科腹腔镜手术患者的研究,由2名研究人员背靠背筛选文献,提取数据及对纳入研究使用Cochrane Risk of Bias工具进行质量评价,并采用RevMan 5.3软件进行meta分析。结果共纳入12项随机对照研究,共计1157例患者。meta分析结果显示:TEAS组术后首次肛门排气时间[MD=-10.06,95%CI(-14.44,-5.67),P<0.00001]、术后首次排便时间[MD=-17.24,95%CI(-18.98,-15.51),P<0.00001]、术后首次闻及肠鸣音时间[MD=-6.69,95%CI(-10.72,-2.65),P=0.001]均明显短于对照组,差异均有统计学意义;TEAS组术后住院时间[MD=-0.75,95%CI(-1.49,-0.01),P=0.05]较对照组缩短,但差异无统计学意义。结论TEAS可有效促进妇科腹腔镜手术患者术后排气、排便,缩短住院时间,在促进术后胃肠功能恢复方面具有良好的临床价值。

Objective To evaluate the effectiveness of transcutaneous electrical acupoint stimulation(TEAS)in promoting gastrointestinal function recovery after gynecological laparoscopy by meta analysis.Methods The databases,including PubMed,Cochrane Library RCT database(CCRCT),Web of Science,Embase,CBM,CNKI,VIP,and Wanfang,were searched systematically.From the establishment of the databases to July 2022,all the studies on TEAS for gynecological laparoscopic surgery were collected.Two researchers screened the literatures back to back,extracted the data and used Cochrane Risk of Bias tools to evaluate the quality of the included studies,and used RevMan 5.3 software for meta analysis.Results A total of 12 randomized controlled trials(RCTs)including 1157 patients were included in this analysis.The meta analysis results showed that the first anal exhaust time[MD=-10.06,95%CI(-14.44,-5.67),P<0.00001],the first defecation time[MD=-17.24,95%CI(-18.98,-15.51),P<0.00001],and the first intestinal sound time[MD=-6.69,95%CI(-10.72,-2.65),P=0.001]in the TEAS group were significantly shorter than those in the control group,with statistically significant differences.The postoperative hospital stay in the TEAS group[MD=-0.75,95%CI(-1.49,-0.01),P=0.05]was shorter than that in the control group,but the difference was not statistically significant.Conclusion TEAS can effectively promote the postoperative exhaust and defecation in gynecological laparoscopic patients,shorten the hospital stay,and has good clinical value in promoting the recovery of postoperative gastrointestinal function.