经皮穴位电刺激对剖宫产术后胃肠道功能恢复的影响

Effect of transcutaneous electrical acupoint stimulation on recovery of gastrointestinal function after cesarean section

目的:探讨剖宫产术后在常规治疗的基础上应用经皮穴位电刺激足三里对胃肠道功能恢复的效果。方法:选择行剖宫产术分娩初产妇110例,随机分为观察组和对照组,各55例。观察组和对照组均给予术后常规处理,观察组术后即刻给予经皮穴位电刺激足三里,将一次性防磁扣皮肤电极贴于足三里及小腿内侧对应部位,采用疏密波(30 Hz/60 Hz),电流15～20 mA,每次治疗30 min,每8小时1次,直至排便后停止。观察两组产妇术后胃肠功能恢复情况(首次肠鸣音恢复时间、首次肛门排气时间及首次排便时间)、初次泌乳时间、并发症发生情况(腹胀、腹痛、恶心等)、术后住院时间及排便后产妇满意度情况。结果:观察组首次肠鸣音恢复时间、首次肛门排气时间、首次排便时间、初次泌乳时间均早于对照组(P<0.01,P<0.05)。观察组术后腹痛、腹胀、恶心等并发症的发生率为3.6%(2/55),低于对照组的16.4%(9/55,P<0.05)。术后住院时间观察组短于对照组(P<0.01)。观察组效果满意率为89.1%(49/55),优于对照组的72.7%(40/55,P<0.05)。结论:剖宫产术后应用经皮穴位电刺激足三里可加快术后胃肠道功能的恢复,减少腹胀、腹痛等并发症发生,缩短住院时间,促进产妇营养摄入和泌乳,产妇的舒适度、满意度提高。

Objective To explore the effect on the recovery of gastrointestinal function after cesarean section treated with transcutaneous electrical acupoint stimulation at Zusanli(ST 36) on the basis of routine treatment. Methods A total of110 primiparas after cesarean section were randomized into an observation group and a control group, 55 cases in each one.The conventional treatment was applied in the two groups, after operation, transcutaneous electrical acupoint stimulation at Zusanli(ST 36) was used immediately in the observation group, the skin electrode of disposable anti-magnetic buckle was attached to Zusanli(ST 36) and the corresponding part of the inner lower leg, with disperse-dense wave, 30 Hz/60 Hz and15-20 mA. The treatment was given for 30 min every time, once every 8 h, until the end of the first bowel movement. The recovery of gastrointestinal function after cesarean section(the restoring time of borborygmus, the time of first anal exsufflation and the first defecation time), the time of secretion of foremilk, complications(abdominal distension, abdominal pain, nausea etc.), hospital stays after operation and the satisfaction of primiparas after bowel movement were compared between the two groups. Results The observation group was superior to the control group in the restoring time of borborygmus, the time of first anal exsufflation, the first defecation time and the time of secretion of foremilk(P<0.01, P<0.05). In the observation group, the incidence of postoperative complications such as abdominal pain, abdominal distension and nausea was 3.6%(2/55), which was lower than 16.4%(9/55) in the control group(P<0.05). Compared with the control group, the observation group had shorter hospital stays(P<0.01). The satisfaction of effect was 89.1%(49/55) in the observation group, which was superior to 72.7%(40/55) in the control group(P<0.05). Conclusion Transcutaneous electrical acupoint stimulation at Zusanli(ST 36) can speed up the recovery of gastrointestinal function after cesarean section, reduce complications such as abdominal pain, abdominal distension, shorten hospital stays, promote patient nutrition intake and lactation, and improve comfort level and satisfaction of primiparas.