经皮穴位电刺激对食管癌根治术后患者睡眠质量的影响

Effect of transcutaneous electrical acupoint stimulation on sleep quality after radical operation for esophageal cancer

目的评价经皮穴位电刺激对食管癌根治术后患者睡眠质量的影响。方法选择拟行食管癌根治术患者150例,性别不限,年龄35~60岁,ASA分级Ⅰ或Ⅱ级,BMI 18.5~25.0 kg/m^2。采用随机数字表法分为3组(n=50):经皮穴位电刺激组(TEAS组)、非电刺激组(NS组)和经皮非穴位电刺激组(TENAS组)。TEAS组于麻醉诱导前10 min至术毕经皮电刺激双侧内关穴及合谷穴,频率2~100 Hz,疏密波型,电流强度6~10 mA;NS组诱导前在相同穴位放置刺激电极片,但不给予电流;TENAS组于麻醉诱导前10 min在非穴位经皮电刺激直至术毕。于术前1 d、术后1、3和7 d时记录患者匹兹堡睡眠质量指数(PSQI)和阿森斯失眠量表(AIS)评分。于术后1和2 d时记录患者康复质量评分量表-15(QoR-15)评分。记录PACU停留时间和术后住院时间。观察患者住院期间主要不良事件的发生情况。结果与NS组和TENAS组比较,TEAS组术后1、3和7 d时PSQI和AIS总分及术后睡眠障碍发生率降低,术后1和2 d时QoR-15评分升高,肺部并发症发生率降低,PACU停留时间和术后住院时间缩短(P<0.05)。3组患者呼吸抑制、窦性心动过缓、窦性心动过速、高血压、低血压和恶心呕吐等不良事件的发生率差异均无统计学意义(P>0.05)。结论经皮穴位电刺激可改善食管癌根治术后患者睡眠质量,促进术后转归。

Objective To evaluate the effect of transcutaneous electrical acupoint stimulation(TEAS)on the sleep quality of patients after radical operation for esophageal cancer.Methods A total of 150 patients of both sexes,aged 35-60 yr,of American Society of Anesthesiology physical statusⅠorⅡ,with body mass index of 18.5-25.0 kg/m2,undergoing elective radical operation for esophageal cancer,were divided into 3 groups(n=50 each)using a random number table method:TEAS group,non-electrical stimulation group(NS group),and transcutaneous electrical non-acupoint stimulation group(TENAS group).In group TEAS,the Neiguan(PC6)and Hegu(L14)acupoints were stimulated staring from 10 min before anesthesia until the end of operation,with a frequency 2-100 Hz,disperse-dense waves and voltage 6-10 mA.In group NS,stimulating electrodes were placed at the same acupoints before induction,but no electrical stimulation was applied.Non-acupoints were stimulated staring from 10 min before anesthesia until the end of operation in group TENAS.The Pittsburgh Sleep Quality Index(PSQI)and Athens Insomnia Scale(AIS)scores were recorded at 1 day before operation and 1,3 and 7 days after operation.The Quality of Recovery-15(QoR-15)scores were recorded.The duration of postanesthesia care unit stay and length of hospital stay were recorded.The development of major adverse events was recorded during hospitalization.Results Compared with group NS and group TENAS,the total scores of PSQI and AIS and incidence of postoperative sleep disorder were significantly decreased at 1,3 and 7 days after operation,and QoR-15 scores were increased at 1 and 2 days after operation,the incidence of pulmonary complications was reduced,and duration of postanesthesia care unit stay and length of hospital stay were shortened in group TEAS(P<0.05).There were no significant differences in the incidence of adverse events such as respiratory depression,sinus bradycardia,sinus tachycardia,hypertension,hypotension,nausea and vomiting among the three groups(P>0.05).Conclusion TEAS can improve the sleep quality of patients after radical operation for esophageal cancer and promote postoperative outcomes.