经皮穴位电刺激对开颅肿瘤切除术术后恶心呕吐的防治作用研究

Effect of Transcutaneous Electrical Acupoint Stimulation on PONV after Craniotomy for Tumor Resection

目的观察经皮穴位电刺激(TEAS)防治开颅肿瘤切除术术后恶心呕吐(PONV)的临床疗效。方法将美国麻醉医师协会(ASA)病情分级Ⅰ~Ⅱ级、择期行开颅肿瘤切除术的84例患者纳入本研究,按随机数字表法随机分为观察组和对照组,每组42例。两组患者缝合硬脑膜时静脉推注阿扎司琼10 mg,术毕观察组予TEAS(取穴为双侧内关、足三里),对照组予假TEAS(取穴同观察组),时间均为30 min。观察患者术后2、6、12、24 h各时点PONV的发生率及严重程度,并记录术后不良反应。结果观察组和对照组术后2 h PONV发生率及严重程度比较差异无统计学意义(P>0.05);术后6、12、24 h,观察组PONV发生率及严重程度低于对照组(P<0.05);观察组术后不良反应发生率为11.90%,低于对照组的30.95%(P<0.05)。结论 TEAS能减少开颅肿瘤切除术患者PONV发生率,降低PONV严重程度,且安全性良好。

Objective： To investigate the clinical efficacy of transcutaneous electrical acupoint stimulation （TEAS） in the prevention and treatment of PONV after craniotomy for tumor resection. Methods： 84 patients were randomly divided into the observation group and the control group,42 cases in each group. Two groups of patients with dural closure was intravenous injected Azasetron 10 mg. After operation,the observation group re-ceived TEAS on Neiguan and Zusanli,while the control group received sham TEAS on the same acupoint. The course lasted for 30 min. 2 h,6 h,12 h,and 24 h after operation,the incidence and severity of PONV at each time were observed,and the adverse reactions were recorded. Results： two hours after operation,there was no statisti-cal significance in the incidence and severity of PONV in the observation group and the control group （P〉0.05）. 6 h,12 h,24 h after operation,the incidence and severity of PONV in the observation group were lower than that in the control group;the difference was statistically significant（P〈0.05）. The incidence of adverse reactions in the observation group was 11.90%,lower than the control group 30.95%（P〈0.05）. Conclusion： TEAS can reduce the incidence of PONV in patients with craniotomy for tumor resection and reduce the severity of PONV,with good safety.