电针联合腹腔镜在老年患者肠道手术快速康复中的疗效观察

Clinical Observation on the Curative Effect of Electroacupuncture Combined with Laparoscopy in Rapid Rehabilitation of Elderly Patients with Bowel Surgery

目的探讨电针治疗联合腹腔镜在老年患者肠道手术快速康复中的作用。方法研究对象选取行腹腔镜肠道手术的老年患者64例,采用随机数字法将其分为电针组(32例)和对照组(32例),2组患者均给予对症治疗,同时电针组给予针刺取穴电针刺激治疗,对照组给予非穴位电针刺激。比较2组患者术后苏醒时间、排气时间、下床时间、住院时间,同时比较2组患者术中失血量、术后VAS评分及术后MMSE评分,以及胰岛素抵抗指数。结果电针组患者的术后苏醒时间、下床时间、排气时间、住院时间显著低于对照组,差异有统计学意义(P<0.05);2组患者术中出血量比较,差异无统计学意义(P>0.05);手术前2组患者的VAS评分及MMSE评分无明显差异(P>0.05),术后3 d电针组的VAS评分显著低于对照组,MMSE评分显著高于对照组(P<0.05),差异有统计学意义(P<0.05);2组患者术前1d的HOMA-IR指数比较,差异无统计学意义(P>0.05)。术后1、3、5d,电针组患者HOMA-IR指数均显著小于对照组(P<0.05),且下降幅度明显大于对照组,差异有统计学意义(P<0.05)。结论电针治疗应用在老年患者腹腔镜肠道手术快速康复中,能减少患者术后麻醉、镇痛药物的使用,促进其肠道功能恢复和减少认知功能障碍,值得推广使用。

Objective:To study the role of electroacupuncture combined with laparoscopy in the rapid rehabilitation of elderly patients with bowel surgery.Methods:64 elderly patients who underwent laparoscopic bowel surgery were selected as the study subjects and were divided into an electroacupuncture group and a control group by random number method.The patients in both groups were given symptomatic treatment and electro-acupuncture at the same time.The acupuncture group was given acupuncture and electroacupuncture stimulation treatment and the control group was given non-acupoint electroacupuncture stimulation.The postoperative wake-up time,get-out-of-bed time,exhaust time and hospital stay were compared between the two groups.At the same time,the intraoperative blood loss,postoperative VAS score,postoperative MMSE score and insulin resistance index of the two groups were compared.Results:The postoperative wake-up time,get-out-of-bed time,exhaust time and hospital stay in the electroacupuncture group were significantly shorter than those in the control group,and the difference was statistically significant(P<0.05).There was no difference in intraoperative blood loss between the two groups and the difference was statistically significant(P>0.05).There was no significant difference in the VAS score and MMSE score of the two groups before surgery(P>0.05).The VAS score of the electroacupuncture group was significantly lower than that of the control group the three days later after surgery,but the MMSE score was significantly higher than that of the control group(P<0.05),and the difference was statistically significant(P<0.05).The comparison of the HOMA-IR index one day before the operation of the two groups was not statistically significant(P>0.05).At the 1st,3rd,and 5th day after operation,the HOMA-IR index of the electroacupuncture group was significantly lower than that of the control group(P<0.05).The decline of the treatment group was significantly greater than that of the control group and the difference was statistically significant(P<0.05).Conclusion:The application of electroacupuncture in the rapid rehabilitation of elderly patients with laparoscopic bowel surgery can reduce the postoperative use of anesthesia and analgesics,promote the recovery of intestinal function and reduce cognitive dysfunction,and is worthy of wide application.