经皮穴位电刺激防治甲状腺手术术后咽喉痛临床疗效观察

Clinical Efficacy Observation of Transcutaneous Electrical Acupoint Stimulation for Prevention of Postoperative Sore Throat After Thyroid Surgery

目的探讨经皮穴位电刺激（TEAS）防治甲状腺手术术后咽喉痛（POST）的临床疗效。方法将120例ASA（美国麻醉医师协会）病情分级Ⅰ～Ⅱ级的拟行甲状腺手术患者采用随机数字表法分为对照组和TEAS组各60例，2组均采用气管插管全麻，TEAS组麻醉诱导前30min至术毕于双侧合谷和内关使用TEAS进行干预，对照组以相同装置置于双侧合谷和内关但不做电刺激，分别记录2组患者术中瑞芬太尼使用量，拔管后1、6、12、24hPOST发生率和严重程度，24h内术后恶心呕吐（PONV）发生率及严重程度，术后24h手术切口疼痛视觉模拟评分（VAS）。结果TEAS组患者术中瑞芬太尼使用量低于对照组（P＜0.05），拔管后各时点POST发生率及严重程度均明显低于对照组（P＜0.05），术后24h内PONV发生率及严重程度均低于对照组（P＜0.05），术后24h手术切口VAS评分低于对照组（P＜0.05）。结论甲状腺手术术中进行TEAS干预可有效降低POST发生率及严重程度。

Objective To investigate the clinical effect of transcutaneous electrical acupoint stimulation (TEAS) for prevention of postoperative sore throat (POST) after thyroid surgery. Methods Totally 120 thyroid surgery patients, ASA Ⅰ or Ⅱ, were randomly assigned into TEAS group (60 cases) and control group (60 cases) by random number table method. All the patients underwent endotracheal intubation anesthesia. TEAS group was continually treated with TEAS at bilateral Hegu (LI4) and Neiguan (PC6) from 30 minutes before induction to the end of operation, and the control group was treated with the same instrument at Hegu and Neiguan but without electrical stimulation. The dose of remifentanyl used during operation, the incidence and severity of POST were recorded at 1,6, 12, and 24 hours after tracheal extubation, respectively.In addition, the incidence and severity of PONV as well as the incision VAS score in two groups were assessed. Results Remifentanyl usage amount in TEAS group was lower than the control group (P<0.05); POST incidence and severity were significantly lower than the control group each time after extubation (P<0.05); the incidence of PONV within 24 h after surgery and severity was lower than the control group (P<0.05); 24 h after surgery incision VAS score was lower than the control group (P<0.05).Conclusion TEAS can reduce the incidence and severity of POST in thyroid surgery patients.