术前电针干预对腹部手术后患者胃肠功能影响的Meta分析

Effect of preoperative electroacupuncture intervention on gastrointestinal function in patients after abdominal surgery:a meta-analysis

目的采用Meta分析方法评价术前电针干预对腹部手术后胃肠功能恢复的影响。方法系统检索PubMed、Cochrane Library、Embase、Web of Science、中国生物医学数据库(CBM)、中国知网(CNKI)、万方(WanFang)和维普(VIP)数据库,检索时间为建库至2024年3月。检索所有关于电针促进术后胃肠功能恢复的随机对照试验(RCT),由2名研究人员独立筛选文献、提取数据,使用Cochrane Risk of Bias工具对纳入研究进行质量评价,并采用RevMan5.3软件进行Meta分析。结果共纳入12篇RCTs,共计773例患者,其中术前电针组421例,对照组352例。Meta分析结果显示,与对照组比较,术前电针组术后首次肛门排气时间(SMD=-0.56,95%CI-0.84~-0.28,P<0.001)、术后首次排便时间(MD=-6.40 h,95%CI-9.27~-3.53 h,P<0.001)、术后肠鸣音恢复时间(MD=-8.45 h,95%CI-10.37~-6.52 h,P<0.001)、术后首次进食时间(MD=-16.88 h,95%CI-23.92~-9.83 h,P<0.001)均明显缩短、术后恶心呕吐(PONV)发生率明显降低(RR=0.75,95%CI 0.57~0.98,P=0.04)、术后住院时间明显缩短(MD=-0.78 d,95%CI-1.38~-0.19 d,P=0.010)。结论手术前电针干预可有效促进手术患者术后排气、排便、肠鸣音恢复,缩短术后禁食禁饮时间,减少PONV的发生率,缩短住院时间,在促进术后胃肠功能恢复方面具有良好的临床价值。

Objective To evaluate the efficacy of preoperative electroacupuncture intervention in promoting postoperative gastrointestinal functional recovery by meta-analysis.Methods The databases of PubMed,Cochrane Library,Web of Science,Embase,CBM,CNKI,VIP,and WanFang were searched systematically.The search period ranged from the inception of the databases to March 2024.Two researchers screened the literature independently,extracted the data,used Cochrane Risk of Bias tools to evaluate the quality of the inclusion study,and used RevMan 5.3 software for meta-analysis.Results Twelve RCTs were included,with 773 patients.There were 421 patients in the preoperative electroacupuncture group and 352 patients in the control group.The results of the meta-analysis showed that,time to first flatus(SMD=-0.56,95%CI-0.84 to-0.28,P<0.001),time to first defecation(MD=-6.40 hours,95%CI-9.27 to-3.53,P<0.001),time to bowel sound recovery(MD=-8.45 hours,95%CI-10.37 to-6.52,P<0.001),time to first oral feeding(MD=-16.88 hours,95%CI-23.92 to-9.83,P<0.001),the incidence of PONV(RR=0.75,95%CI 0.57 to 0.98,P=0.04)and length of hospital stay(MD=-0.78 d,95%CI-1.38 to-0.19,P=0.010)were significantly lower than the control group.Conclusion Electroacupuncture intervention before operation can effectively promote the recovery of postoperative exhaust,defecation,and bowel sound,shorten the time of fasting and drinking,reduce the incidence of PONV,shorten the length of hospital stay,and has good clinical value in promoting the recovery of postoperative gastrointestinal function.