电针对全麻腹腔镜胆囊切除术后患者胃肠功能的影响

Effect of electroacupuncture on gastrointestinal function of patients after laparoscopic cholecystectomy under general anesthesia

目的:观察电针双侧足三里、上巨虚、三阴交对全麻腹腔镜胆囊切除术后患者胃肠功能的影响。方法:将150例行全麻腹腔镜胆囊切除术的患者随机分为对照组、单纯针刺组和电针组,每组50例。对照组给予常规治疗;单纯针刺组在常规治疗基础上予双侧足三里、上巨虚、三阴交针刺治疗,留针30min;电针组在常规治疗基础上予双侧足三里、上巨虚、三阴交电针治疗,留针30min。单纯针刺组和电针组在术后1h、术后次日上午、术后次日下午分别进行相应治疗。记录术后患者肠鸣音恢复时间、首次排气时间、首次排便时间、恢复流质饮食时间,观察治疗前后患者腹部胀痛评分、胃肠反应评分,并评价其临床疗效。结果:与对照组比较,单纯针刺组、电针组术后患者肠鸣音恢复时间、首次排气时间、首次排便时间、恢复流质饮食时间均明显缩短(P<0.01);且电针组较单纯针刺组缩短更显著(P<0.01)。与本组治疗前比较,3组术后患者腹部胀痛评分、胃肠反应评分均明显降低(P<0.01);治疗后,与对照组比较,单纯针刺组、电针组腹部胀痛评分、胃肠反应评分降低更显著(P<0.01)。对照组总有效率为78.0%(39/50),单纯针刺组总有效率为88.0%(44/50),电针组总有效率为94.0%(47/50),单纯针刺组、电针组临床疗效优于对照组(P<0.05)。结论:电针或单纯针刺均可促进全麻腹腔镜胆囊切除术后患者的胃肠功能恢复,且电针的治疗效果优于单纯针刺,但两者在改善患者术后的腹部胀痛、胃肠反应等方面无明显差异。

Objective To observe the effects of electroacupuncture at bilateral Zusanli(ST36),Shangjuxu(ST37),and Sanyinjiao(SP6)acupoints on gastrointestinal function after laparoscopic cholecystectomy under general anesthesia.Methods A total of 150patients(American Society of Anesthesiologists[ASA]gradesⅠandⅡ)undergoing laparoscopic cholecystectomy in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Guangzhou University of Chinese Medicine were randomly assigned into three groups:electroacupuncture group(n=50),simple acupuncture group(n=50),and control group(n=50).Patients in the control group received routine treatment;on the basis of routine treatment,patients in the simple acupuncture group were acupunctured at bilateral ST36,ST37and SP36;patients in the electroacupuncture group were treated with electroacupuncture at bilateral ST36,ST37and SP36(50Hz,5mA).In both simple acupuncture group and electroacupuncture group,the corresponding treatments were conducted 1hafter surgery,Patients as well as in the morning(8:00-10:00)and afternoon(14:00-16:00)on the first day after surgery,30min each time.The time of bowel sound recovery,the time to the first postoperative exhaust and defecation,the time of postoperative fluid diet recovery,abdominal pain score,and gastrointestinal reaction score were recorded and analyzed.Results Compared with the control group,the electroacupuncture group and the simple acupuncture group showed shortened time of bowel sound recovery,shortened time to the first postoperative exhaust and defecation,and shortened time of postoperative liquid diet recovery(P<0.01),as well as decreased postoperative abdominal pain score and gastrointestinal reaction score(P<0.01).Furthermore,the time of bowel sound recovery,the time to the first postoperative exhaust and defecation,and the time of postoperative liquid diet recovery were shortened in the electroacupuncture group compared with those in the simple acupuncture group(P<0.01).The total effective rate of electroacupuncture group was 94.0%(47/50),the total effective rate of simple acupuncture group was 88.0%(44/50),significantly higher than 78.0%(39/50)in the control group(P<0.05).Conclusion Both electroacupuncture and simple acupuncture can promote the recovery of gastrointestinal function in patients after laparoscopic cholecystectomy under general anesthesia,and electroacupuncture is superior to simple acupuncture,but they have no significant difference in alleviating postoperative abdominal pain and gastrointestinal reactions.