经皮电刺激预防开颅术后恶心呕吐的效果评价

Effect evaluation of percutaneous electrical stimulation on Neiguan acupoint in prevention of nausea and vomiting after craniotomy

目的探讨经皮电刺激内关穴对开颅手术后恶心呕吐的预防效果。方法选择2011年3-6月在复旦大学附属华山医院神经外科择期行幕下肿瘤开颅切除术患者90例,随机分为实验组45例和对照组45例。两组患者均接受标准化的全身麻醉方案,术中均给予昂丹司琼和地塞米松治疗。实验组自手术结束时给予经皮电刺激内关穴,直至术后24 h。记录两组患者术后24 h内的恶心呕吐发生以及应用止吐药情况。结果 96例患者中77例完成试验。实验组术后24 h内呕吐发生率为17.9%,对照组为39.4%,两组比较差异有统计意义(P<0.05);术后24 h内恶心发生率,实验组也显著低于对照组,两组比较差异有统计学意义(P<0.05)。两组患者使用止吐药比较差异无统计学意义(P>0.05)。结论经皮电刺激内关穴能有效降低幕下肿瘤开颅切除术后恶心呕吐的发生率,有利于减轻患者手术后的不良反应,对患者手术后的早日康复有积极的推动作用。

Objective To study the effect of percutaneous electrical stimulation on Neiguan acupoint on preven- tion of nausea and vomiting after craniotomy. Methods A total of 90 patients in our hospital accepting infraten- torial craniotomy for tumor resection from March to June 2011 were randomly divided into the control group and experimental group, with 45 patients in each group. The two groups received standardized anesthesia and were given ondansetron and dexamethasone during the surgery. The experimental group accepted percutaneous electri- cal stimulation on Neiguan acupoint at the end of the surgery,lasting 24 h. The nausea and vomiting in the two groups were recorded. Results Seventy-seven patients completed the study. Within 24 h after the surgery, the incidence of vomiting in the experimental group was 17.9% , while 39.4% in the control group （ P 〈 0.05 ）. The incidence of nausea in the experimental group was significantly lower than that in the control group （ P 〈 0.05 ）. There was no significant difference in the use of antiemetic （ P 〉 0.05 ）. Conclusion Percutaneous electrical stimulation on Neiguan acupoint can effectively prevent nausea and vomiting after eraniotomy.