经皮穴位电刺激预防患者术后静脉血栓形成的Meta分析

Transcutaneous acupoint electrical stimulation to prevent venous thrombosis in postoperative patients:a Meta-analysis

目的系统评价经皮穴位电刺激在预防术后患者静脉血栓中的效果。方法通过计算机检索Cochrane图书馆、Web of Science、PubMed、Embase、中国知网、中国生物医学数据库、维普数据库和万方数据库,检索关于穴位电刺激干预手术患者以预防静脉血栓的随机对照研究(Randomized controlled study,RCT),使用RevMan 5.3软件进行Meta分析,比较静脉血栓发生情况、静脉血流速度、凝血酶原时间等。结果纳入14篇研究,涉及1169例患者。Meta分析结果显示,经皮穴位电刺激可改善VTE发生率[OR=0.22,95%CI(0.13,0.35),P<0.00001]、静脉血流速度[SMD=0.65,95%CI(0.43,0.88),P<0.00001]、凝血酶原时间[MD=0.7,95%CI(0.30,1.09),P=0.0005]、活化部分凝血酶原时间[MD=2.63,95%CI(1.07,4.19),P=0.001]和D-二聚体[SMD=-4.93,95%CI(-6.80,-3.06),P<0.00001]水平。结论经皮穴位电刺激可以有效预防术后患者静脉血栓的形成,但证据质量水平较低,仍需高质量的RCT临床试验来进一步验证分析其疗效。

To systematically evaluate the effects of transcutaneous acupoint electrical stimulation of prevention of venous thrombosis with postoperative patients.Methods A computerized search was performed through the Cochrane Library,Web of Science,PubMed,EMBASE,the China National Knowledge Infrastructure,the Chinese Biomedical Database,VIP Database and Wanfang Database for Randomized Controlled Trials(RCTs)which studied the preventive effect of transcutaneous acupoint electrical stimulation on venous thrombosisin postoperative patients.Revman 5.3 software was used for meta-analysis to compare the occurrence of venous thrombosis,venous blood flow velocity,prothrombin time,etc.Results The results of meta-analysis showed that percutaneous acupointelectrical stimulation could improve the incidence of VTE[OR=0.22,95%CI(0.13,0.35),P<0.00001],venous blood flow velocity[SMD=0.65,95%CI(0.43,0.88),P<0.00001],prothrombin time[MD=0.7,95%CI(0.30,1.09),P=0.0005],activated partial prothrombin time[MD=2.63,95%CI(1.07,4.19),P=0.001]and D-dimer[SMD=-4.93,95%CI(-6.80,-3.06),P<0.00001].Conclusion Transcutaneous acupoint electrical stimulation can effectively prevent the formation of venous thrombosis in postoperative patients.But the quality of evidence is still at a lower level.Therefore,RCTs with more high quality should be conducted,in order to further verify and analyze curative effect.