术前穴位电针刺激对结直肠癌根治术患者术后恢复的影响

Effect of Preoperative Acupoint Electroacupuncture Stimulation on Postoperative Recovery of Patients Undergoing Radical Colorectal Cancer

目的探讨术前穴位电针刺激对结直肠癌根治术患者术后恢复的影响。方法96例行结直肠癌根治术患者随机分为对照组、电针①组、电针②组,每组32例,对照组为全凭静脉麻醉组,电针①组为术前1天穴位电针刺激组,电针②组为术前1天加术前30 min穴位电针刺激组,三组均采用全凭静脉麻醉,术后给予镇痛处理。术前1天及术前30 min均行电针刺激膻中穴、中庭穴、双侧内关穴及双侧足三里(刺激电流:2~3 mA,频率:2/100 Hz,持续时间:30 min)。记录术后呼吸恢复时间、拔管时间、入麻醉恢复室(PACU)的清醒评分、Steward评分、PACU停留时长、出PACU清醒评分、Steward评分、VAS评分、ROMEⅢ评分及GIR评分,分别记录手术时长、麻醉时长,通气时间、进食时间和腹腔引流量(观察并记录腹腔引流管术后3天引流液总量)。结果电针②组、电针①组和对照组比较,术后呼吸恢复时间与拔管时间更短,T1的腹胀ROMEⅢ评分较低,T1、T2的VAS评分较低(P均<0.05)。电针②组与对照组和电针①组比较,入PACU的清醒评分较高,PACU停留时长更短,术后3 d的腹腔引流液量更多、通气时间、进食时间更短(P均<0.05)。三组间入出PACU的Steward评分、出PACU的清醒评分、T3的VAS评分、T1、T2、T3的GIR评分比较差异均无统计学意义(P均>0.05)。结论术前穴位电针刺激能够促进患者麻醉手术后呼吸恢复,加快术后清醒,缓解术后疼痛,减少腹胀恶心。

Objective To investigate the effect of preoperative acupoint electroacupuncture stimulation on postoperative recovery of patients undergoing radical resection of colorectal cancer.Methods A total of 96 patients who underwent radical resection of colorectal cancer were randomly divided into control group,EA①group,EA②group,with 32 cases in each group.The control group was intravenous anesthesia group,the EA①group was acupoint electroacupuncture stimulation group 1 day before surgery,and EA②group was acupoint electroacupuncture stimulation group 1 day before surgery plus 30 minutes before surgery,all three groups were given intravenous anesthesia,postoperative analgesia treatment.Electroacupuncture stimulation of Shanzhong,Zhongting,bilateral Neiguan,and bilateral Zusanli was performed on the day before surgery and 30min before surgery,with the intensity of 2~3 mA and frequency of 2/100 Hz for 30 min.Postoperative respiratory recovery time,extubation time,Score of wakefulness of admission to Postanesthesia care unit(PACU),Steward score,PACU stay time,Score of wakefulness and Steward score were recorded when entering and leaving PACU.VAS score,ROMEⅢscore and GIR score on the first day(T1),second day(T2)and third day(T3)after surgery were recorded,respectively.Operation duration,anesthesia duration,Intestinal ventilation time,feeding duration and abdominal drainage volume were recorded.Results The postoperative respiratory recovery time and extubation time were shorter,the abdominal distension ROMEⅢscore was lower in T1,and the VAS score was lower in T1 and T2(P all<0.05),EA②,EA①and control group were compared,EA②and EA①were compared.Compared with the control group and the EA①group,the awake score of the EA②group in PACU was higher,the PACU stay time was shorter,the abdominal drainage volume was more,the ventilation time and the feeding time were shorter 3 days after operation(P all<0.05).There were no significant differences in Steward score,sobriety score of PACU,VAS score of T3,GIR score of T1,T2 and T3 among the three groups(P all>0.05).Conclusion Preoperative acupoint electroacupuncture stimulation can promote respiratory recovery after anesthesia,accelerate postoperative wakefulness,relieve postoperative pain,reduce nausea and abdominal distension.