摘要
目的:观察子午流注理论指导下经皮穴位电刺激预防妇科腹腔镜手术术后恶心呕吐的效果。方法:将96例择期全身麻醉下行妇科腹腔镜手术患者,按照随机数字表法分为对照组和观察组各48例。两组患者均常规麻醉诱导及术中维持,观察组结合子午流注法,于麻醉诱导前和术毕在恢复室苏醒期间接受经皮穴位电刺激治疗30 min,对照组只贴电极片,不予其电刺激。比较两组术后恶心呕吐的发生率、恶心呕吐严重程度[视觉模拟评分法(VAS)评估]、血清胃动素(MTL)水平、5-羟色胺(5-HT)水平、其他不良反应的发生率。结果:观察组术后24 h内恶心、呕吐的发生率分别为6.25%、2.08%,均低于对照组的20.83%、14.58%(P<0.05);术后48 h内,观察组恶心、呕吐总发生率分别为10.42%、4.17%,低于对照组的27.08%、16.67%(P<0.05);术后24 h、术后48 h,观察组恶心呕吐程度的VAS评分均低于对照组(P<0.05);术后12 h,两组患者血清中MTL水平均高于术前,5-HT水平低于术前(P<0.05),且观察组MTL、5-HT水平低于对照组(P<0.05);观察组其他不良反应的发生率6.25%,对照组16.67%,两组比较,差异无统计学意义(P>0.05)。结论:子午流注理论指导下经皮穴位电刺激可降低妇科腹腔镜手术术后恶心呕吐的发生率,减轻恶心呕吐程度,机制可能与阻止MTL升高、促使5-HT下降有关,且不增加不良反应风险。
Objective:To observe the effect of percutaneous acupoints electrical stimulation on the prevention of postoperative nausea and vomiting after gyneco⁃logical laparoscopic surgery unser the guidance of the theory of midnight-midday ebb flow.Methods:A total of 96 patients scheduled for gynecological laparoscopic surgery under general anesthesia were divided into a control group and an observation group,with 48 cases in each group,according to the random number table method. Both groups of patients received conventional anesthesia induction and intraoperative maintenance. The observation group,in combination with the midnight-midday ebb flow method,received percutaneou acupoints electrical stimulation treatment for 30 minutes before anesthesia induction and during the recovery period in the recovery room after surgery. The control group only had electrode patches attached and was not given electrical stimulation. The incidence of postoperative nausea and vomiting,the severity of nausea and vomiting [assessed by Visual Analogue Scale(VAS)],the levels of serum motilin(MTL) and 5-hydroxytryptamine(5-HT),and the incidence of other adverse reactions were compared between the two groups. Results:The incidences of nausea and vomiting within 24 hours after surgery in the observation group were 6.25% and 2.08% respectively,which were lower than 20.83% and 14.58% in the control group(P<0.05). Within 48 hours after surgery,the total incidence of postoperative nausea and vomiting in the observation group was 10.42% and 4.17% respectively, which were lower than 27.08% and 16.67% in the control group(P<0.05). At 24 hours and 48 hours after surgery,the VAS scores of the degree of nausea and vomiting in the observation group were lower than those in the control group(P<0.05). At 12 hours after surgery,the levels of MTL in the serum of both groups of patients were higher than those before surgery,while the levels of 5-HT were lower than those before surgery(P<0.05),and the levels of MTL and 5-HT in the observation group were lower than those in the control group(P<0.05). The incidence of other adverse reactions was 6.25% in the observation group and 16.67% in the control group. There was no statistically significant difference between the two groups(P> 0.05). Conclusions:Percutaneous acupoints electrical stimulation can reduce the incidence of postoperative nausea and vomiting after gynecological laparoscopic surgery and alleviate the degree of nausea and vomiting unser the guidance of the theory of midnight-midday ebb flow. The mechanism may be related to preventing the increase of MTL and promoting the decrease of 5-HT,without increasing the risk of adverse reactions.
作者
毛琦
丛仔红
牛西武
朱博
MAO Qi;CONG Zihong;NIU Xiwu;ZHU Bo(Surgical Anesthesia Center of Xianyang First People’s Hospital,Xianyang 712099,China;Department of Traditional Chinese Medicine of Xianyang First People’s Hospital,Xianyang 712099,China)
出处
《山东中医杂志》
2025年第8期902-907,共6页
Shandong Journal of Traditional Chinese Medicine
基金
咸阳市重点研发计划(编号:L2023ZDYF-SF-064)。
关键词
子午流注法
经皮穴位电刺激
妇科腹腔镜手术
术后恶心呕吐
胃肠激素
神经递质
the theory of midnight-midday ebb flow
percutaneous acupoints electrical stimulation
gynecological laparoscopic surgery
postoperative nausea and vomiting
gastrointestinal hormone
neurotransmitter
