经皮穴位电刺激辅助全身麻醉可减轻妇科腹腔镜手术的术后反应.pdf

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1、针刺研究2013年12月第38卷第6期☆针刺麻醉☆经皮穴位电刺激辅助全身麻醉可减轻妇科腹腔镜手术的术后反应殷岫绮周一辰周华杨红王永强张翮。(上海中医药大学附属曙光医院，妇科，。麻醉科，上海201203；。上海中医药大学附属龙华医院针灸科，上海200032)【摘要】目的：观察经皮穴位电刺激联合全身麻醉是否能改善妇科腹腔镜术后患者的疼痛及胃肠道症状。方法：将60例择期行妇科腹腔镜手术的患者随机分为对照组和观察组，每组3O例。对照组行全身麻醉；观察组行经皮穴位电刺激结合全身麻醉，取双侧足三里、梁丘穴，连接韩氏穴位神经刺激仪，2Hz连续波，电流强度由弱至强，逐渐达到患者能耐受的最大量(不超

2、过2mA)，刺激持续30min后进行全身麻醉，直至手术结束。观察患者术后8、24、72h的视觉模拟评分(VAS)值，恶心、呕吐评级，术后排气、排便时间。结果：①观察组术后VAS值在各时间点均较对照组降低(P<0．01)；②观察组术后恶心程度较对照组减轻(P<0．05)，呕吐程度较对照组也有一定程度的减轻，但差异无统计学意义(P>0．05)；③观察组术后排气、排便时间均较对照组提前(P<0．01)。结论：经皮穴位电刺激联合全身麻醉可以缓解患者术后疼痛，减少恶心、呕吐次数及程度，加快肠功能的恢复。【关键词】经皮穴位电刺激妇科腹腔镜手术针刺复合麻醉【中图分类号】R245．97【文献标志码

3、】A【文章编号】1000—0607(2013)06—0431—04EffectofTranscutaneousElectricalStimulationofZusanli(ST36)andLiangqiu(ST34)Com-binedwithGeneralAnesthesiaonPainandGastrointestinalSymptomsinPatientsUndergoingGynecoJOgicalLaparoscOpjcOperationYINXiu—qi，ZHOUYi—chen，ZHOUHua，YANGHong，WANGYong—qiang，ZHANGHe。(Depart

4、mentofGynecology，DepartmentofAPs^P00g，ShuguangHospitalAffiliatedtoShanghaiUniversityofTraditionalChineseMedicine，Shanghai201203，China；。DepartmentofAcu—moxibustion，LonghuaHospitalAffiliatedtoShanghaiUniversi—tyofTraditionalChineseMedicine，Shanghai200032)[ABSTRACT]ObjectiveToobservetheefectsoftr

5、anscutaneousacupointelectricalstimulation(TAES)combinedwithgeneralanesthesia(acupunctureanalgesiacombinedwithgeneralanesthesia)onpostoperativepain，nauseaandvomitingandex—hausteddefecationsymptomsinpatientsundergoinggynecologicallaparoscopicoperation．MethodsSixtypatientswithgyne—cologicallaparo

6、scopicoperationwererandomlydividedintoTAESgroupandcontrolgroup，with30casesineachgroup．PatientsofthecontrolgroupreceivedsimplegeneralanesthesiaandthoseoftheTAESgroupweretreatedwithgeneralanesthesiaandTAESofbilateralZusanli(ST36)andLiangqiu(ST34)VisualAnalogueScale(VAS)wasusedformeasuringthepati

7、ents’painreactionat8h。24hand72haftersurgery．Symptomsofpatients’nauseaandvomiting，post—operationexhaustanddefecationtimewererecordedafteroperation．ResultsTheVASscoresattimepointsof8h，24hand72handnausealevelintheTAESgroupweresignificantly