经皮多穴位电刺激对预防胸腔镜下肺叶切除术患者术后恶心呕吐的影响

发布时间：2018-01-01 18:27

本文关键词：经皮多穴位电刺激对预防胸腔镜下肺叶切除术患者术后恶心呕吐的影响　出处：《临床麻醉学杂志》2016年04期 　论文类型：期刊论文

【摘要】：目的观察经皮电刺激合谷-内关-后溪-支沟穴对胸腔镜下肺叶切除术患者术后恶心呕吐(PONV)的影响。方法选择择期胸腔镜下肺叶切除术患者64例,年龄18~75岁,采用随机数字表法分为两组,每组32例。麻醉诱导前30min于患者双侧合谷、内关、后溪及支沟穴连接经皮穴位电刺激仪进行电刺激,设置频率为2/100Hz,经皮穴位电刺激(TEAS)组(E组)电刺激强度为引起感觉阈的2倍,经皮穴位假电刺激组(C组)电刺激强度仅为引起感觉阈的强度。E组患者于诱导结束后继续经皮穴位电刺激,强度为30mA,直至手术结束,C组不给予经皮电刺激。术中维持采用血浆靶控输注丙泊酚和瑞芬太尼,两组患者术后均采用静脉自控镇痛(PCIA),术前及手术过程中均不给予止吐药物。术后6、24和48h对患者进行30min经皮电刺激,E组和C组的频率和强度均与麻醉诱导前30min一致。随访患者PONV情况、使用补救止吐药物情况、VAS疼痛评分及镇痛泵舒芬太尼用量。结果与C组比较,E组拔管后即刻、术后6、24、48h恶心发生率均明显降低,术后24h的呕吐发生率明显降低,术后6h及术后24h的VAS评分明显降低,术后48h的镇痛泵舒芬太尼用量明显减少(P0.05)。两组患者术后使用补救止吐药物差异无统计学意义。结论经皮穴位电刺激合谷-内关-后溪-支沟穴对预防PONV有效。
[Abstract]:Objective to observe the effect of percutaneous electrical stimulation of Hegu-Neiguan-Houxi-Zhigou on postoperative nausea and vomiting PONVs in patients undergoing thoracoscopic lobectomy. Methods 64 patients with elective thoracoscopic lobectomy were selected. The age was 1875 years old. The patients were randomly divided into two groups, 32 cases in each group. 30 minutes before anesthesia induction, the patients were divided into two groups: Hegu and Neiguan. Hexi and Zhigou acupoints were connected to the transcutaneous acupoint electrical stimulator for electrical stimulation. The frequency was 2 / 100 Hz. The electric stimulation intensity of the transcutaneous acupoint electric stimulation group was 2 times as high as the sensory threshold. The intensity of electrical stimulation was only the intensity of sensory threshold. The patients in group E continued the electrical stimulation of percutaneous acupoint after induction, the intensity was 30mAuntil the end of operation. Group C did not receive percutaneous electrical stimulation. Plasma target-controlled infusion of propofol and remifentanil was used during operation. Patients in group C were treated with PCIA after operation. No antiemetic drugs were given before and during the operation. The patients were treated with percutaneous electrical stimulation for 30 minutes at 6: 24 and 48 hours postoperatively. The frequency and intensity of group E and group C were the same as those of 30 minutes before anesthesia induction. The patients were followed up with PONV and the use of remedial antiemetic drugs. Results compared with group C, the incidence of nausea in group E was significantly lower than that in group C at 24 hours after extubation. The incidence of vomiting at 24 hours after operation was significantly decreased, and the VAS scores at 6 hours and 24 hours after operation were significantly decreased. 48 hours after operation, the dosage of sufentanil decreased significantly (P 0.05). There was no significant difference between the two groups in using remedial antiemetic drugs after operation. Conclusion Percutaneous acupoint electrical stimulation of Hegu-Neiguan-Houxi-Zhigou is effective in preventing PONV.
【作者单位】：北京大学肿瘤医院暨北京市肿瘤防治研究所麻醉科恶性肿瘤发病机制及转化研究教育部重点实验室;
【分类号】：R614
【正文快照】： Effect of transcutaneous multi-electrical acupoint stimulation for prevention of PONV in patients under-going thoracoscopic lobectomy LI Xiaoxi,CHEN Jiheng,FAN Zhiyi,ZHANG Yunxiao.Key Labo-ratory of Carcinogenesis and Translational Research(Ministry of E

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