电针促进腹腔镜胃癌根治术患者胃肠功能恢复:随机对照试验

Electroacupuncture promotes gastrointestinal function recovery in patients undergoing laparoscopic gastrectomy:a randomized controlled trial

目的:探究电针促进腹腔镜胃癌根治术患者胃肠功能恢复的临床效应。方法:将120例腹腔镜胃癌根治术患者随机分为电针组(40例,剔除1例)、安慰电针组(40例,脱落1例)和常规治疗组(40例,脱落1例)。常规治疗组患者接受围手术期常规治疗;电针组和安慰电针组患者在常规治疗基础上,于麻醉苏醒后24、48、72 h分别予以电针或安慰电针刺激,穴取双侧内关、足三里、上巨虚,同侧足三里、上巨虚分别接SDV-Z型电针仪电极,选用连续波,频率5 Hz,每次留针30 min。比较各组患者术后经口耐受固体饮食时间与首次肛门排成形便时间的综合结果 (GI-2)时间、胃排空延迟A/B级发生率,评价针刺安全性。结果:电针组GI-2时间较安慰电针组和常规治疗组GI-2时间缩短(P<0.05),电针组患者胃排空延迟A级发生率、B级发生率均较安慰电针组和常规治疗组降低(P<0.05),未发生针刺相关不良反应。结论:电针可促进腹腔镜胃癌根治术患者胃肠功能恢复,且治疗方案安全,值得融入加速康复外科方案。

Objective To explore the clinical effect of electroacupuncture(EA)on promoting gastrointestinal function recovery in patients undergoing laparoscopic gastrectomy.Methods One hundred and twenty patients undergoing laparoscopic gastrectomy were randomly divided into an EA group(40 cases,1 case was eliminated),a placebo EA(PEA)group(40 cases,1 case dropped out)and a conventional treatment group(40 cases,1 case dropped out).The patients in the conventional treatment group received perioperative routine treatment.On the basis of routine treatment,patients in the EA group and the PEA group were given electroacupuncture or placebo electroacupuncture stimulation at 24,48 and 72 h after anesthesia recovery.Bilateral Neiguan(PC 6),Zusanli(ST 36)and Shangjuxu(ST 37)were selected,and the electrodes of SDV-Z electroacupuncture instrument were connected to Zusanli(ST 36)and Shangjuxu(ST 37)on the same side respectively.Continuous wave was selected,the frequency was 5 Hz,and the needles were retained for 30 min each time.The postoperative gastrointestinal-2(GI-2)time,the incidence of grade A/B delayed gastric emptying were compared among the three groups,and the safety of acupuncture was evaluated.Results The GI-2 time of the EA group was significantly shorter than that of the PEA group and the conventional treatment group(P<0.05).The incidence of grade A and grade B of delayed gastric emptying in the EA group was lower than that in the PEA group and the conventional treatment group(P<0.05).No acupuncture-related adverse reactions occurred.Conclusion EA can promote the recovery of gastrointestinal function in patients undergoing laparoscopic gastrectomy,and the treatment plan is safe,which is worthy of promotion and application into the enhanced recovery surgery program.