不同频率电针对腹腔镜手术病人术后恶心呕吐的影响

Impacts of electroacupuncture at different frequencies on the postoperative nausea and vomiting of patients with laparoscopic surgery

目的:评价采用不同频率电针刺激双侧内关穴对全身麻醉腹腔镜手术病人术后发生恶心与呕吐的影响,探讨理想电针参数。方法:将全身麻醉下行腹腔镜手术的女性病人120例随机分为4组:2Hz电针治疗组(A组)、2Hz/100Hz电针治疗组(B组)、100Hz电针治疗组(C组)和对照组(D组),每组30例。各组均接受相同麻醉处理方案,A、B、C 3组病人均在常规药物麻醉开始前半小时针刺双侧内关穴,得气后连接HANS-200A电针仪,频率分别为2Hz、2Hz/100Hz、100Hz,手术结束后停止电针刺激。D组不予电针。观察记录各组病人手术结束后生命体征、术后恶心与呕吐的发生情况及术后恶心与呕吐的严重程度分级。结果:各组病人术后1h心率、平均动脉压(MAP)、指脉氧饱和度、呼吸频率差异无统计学意义(均P>0.05);B组病人术后恶心呕吐发生率明显低于A、C、D组[10.0%(3/30)vs 30.0%(9/30)、36.7%(11/30)、53.3%(16/30),均P<0.01];B组病人术后恶心呕吐严重程度明显低于其他3组(均P<0.01)。结论:2Hz/100Hz电针可有效减少行全身麻醉腹腔镜手术病人术后恶心呕吐发生率,减低病人恶心呕吐的严重程度。

Objective To assess the impacts on postoperative nausea and vomiting of the patients with laparo- scopic surgery undergoing the general anesthesia by electroacupuncture （EA） at different frequencies at bilateral Neiguan （PC 6）. Methods One hundred and twenty female patients with laparoscopic surgery undergoing the ge- neral anesthesia were randomized into 4 groups.. 2 Hz EA treatment group （group A）, 2 Hz/100 Hz EA treatment group （group B）, 100 Hz EA treatment group （group C） and a control group （group D）, 30 cases in each one. The same anesthetic program was adopted in each group. For the patients in A, B and C groups, in the first half a hour undergoing the conventional drug anesthesia, acupuncture was applied to bilateral Neiguan （PC 6）. After ar- rival of qi, HANS-200A electroacupuneture apparatus was connected, at the frequency as 2 Hz, 2 Hz/100 Hz and 100 Hz separately. The electric stimulation was discontinued at the end of surgery. The life physical signs after surgery, the occurrence of postoperative nausea and vomiting and the severity grades of postoperative nausea and vomiting were observed and recorded for the patients in each group. Results The differences in the postoperative 1 h heart rate, mean arterial pressure （MAP）, finger pulse oxygen saturation and respiratory frequency were not significant statistically in comparison of the patients among groups （all P〉0.05）. The incidence of postoperative nausea and vomiting of the patients in group B was lower apparently than that in A, C and D groups F10.0% （3/30） vs 30.0% （9/30）, 36.7% （11/30）, 53.3% （16/30）, all P^0.01]. The severity of postoperative nausea and vomiting of the patients in group B was lower apparently than that in the rest three groups （all P〈 0.01）. Conclusion The eleetroacupuncture at 2 Hz/100 Hz reduces effectively the incidence and the severity of postopera- tive nausea and vomiting of the patients with laparoscopic surgery undergoing the general anesthesia.