Effect of electroacupuncture at different time points on the recovery of gastrointestinal function after surgery for gastrointestinal malignant neoplasms

不同时机电针对胃肠恶性肿瘤术后胃肠功能恢复的影响

Objective To observe the effect of electroacupuncture(EA)at different time points during the perioperative period on the recovery of gastrointestinal function after gastrointestinal malignant neoplasms surgery.Methods Sixty-three patients who needed radical surgery for gastrointestinal tumors were randomized into a control group,treatment group 1(postoperative EA group),and treatment group 2(intraoperative and postoperative EA group).The control group received surgery and conventional Western medicine treatment,and treatment groups 1 and 2 received additional EA treatment at different time points.The initial flatus time after the surgery,visual analog scale(VAS)score at different time points after the surgery,the proportion of using patient-controlled analgesia(PCA)after the surgery,and the times of adding analgesics were observed in the three groups.Results The initial flatus time after the surgery was earlier in treatment groups 1 and 2 than in the control group(P<0.05);the difference between treatment groups 1 and 2 was statistically insignificant(P>0.05).The VAS score was lower in treatment group 2 than in the control group at 6,12,24,and 72 h after the surgery(P<0.05);the VAS score was lower in treatment group 1 than in the control group only at 72 h after the surgery(P<0.05).There were no significant differences in the rate of using PCA among the three groups(P>0.05).Regarding the times of adding analgesics,it was less in treatment group 2 than in the control group at 12 h after the surgery(P<0.05).Conclusion Either EA during and after the surgery or only after the surgery can hasten the initial flatus and boost the recovery of gastrointestinal function in patients after radical resection of gastrointestinal neoplasms.Successive EA during and after the surgery should be superior to postoperative EA regarding the analgesic effect after the surgery.

目的观察围手术期不同时机电针介入对胃肠恶性肿瘤术后胃肠功能恢复的影响.方法将63名需行胃肠道肿瘤根治术的患者随机分为对照组、治疗1组(术后电针组)、治疗2组(术中加术后电针组).对照组给予手术和西医常规治疗,治疗1组和治疗2组分别在对照组治疗基础上加用不同时机电针治疗.观察三组患者术后首次排气时间、术后不同时间点的疼痛视觉模拟量表(VAS)评分、术后使用镇痛泵的比例及追加镇痛药的次数.结果治疗1组及治疗2组术后首次排气时间均早于对照组(P<0.05),但治疗1组和治疗2组比较差异无统计学意义(P>0.05);治疗2组术后6、12、24及72 h的疼痛VAS评分均低于同时间点对照组(P<0.05),而治疗1组术后疼痛VAS评分仅在术后72 h低于对照组(P<0.05);三组患者术后镇痛泵使用率比较差异无统计学意义(P>0.05);追加镇痛药次数方面,治疗2组术后12 h追加镇痛药次数少于对照组(P<0.05).结论术中加术后及术后两种电针介入时机均可以缩短患者术后首次排气时间,促进胃肠道肿瘤根治术患者术后胃肠功能恢复.在术后镇痛作用上,术中加术后的序贯电针处理优于术后电针.