经皮穴位电刺激对剖宫产产妇机体功能恢复的影响

目的观察经皮穴位电刺激(TEAS)对剖宫产产妇常见并发症和机体功能恢复的影响。方法择期行剖宫产术初产妇80例,年龄22~40岁,BMI 18~32 kg/m^2,ASAⅠ或Ⅱ级,采用随机数字表法随机分为TEAS联合麻醉组(T组)和常规麻醉组(C组),每组40例。两组均采用腰-硬联合阻滞,术后镇痛方法相同:采用患者自控硬膜外镇痛(PCEA)。T组于术前30 min给予经皮穴位电刺激双侧内关、合谷穴,术中持续刺激至术毕;C组不贴电极片。记录两组产妇年龄、体重、手术时间、出血量、术中液体输注量等一般情况,术后PCEA维持VAS评分≤3分,记录产妇48 h内PCEA镇痛药用量、羟考酮补救镇痛消耗量,恶心呕吐发生率和评分、寒战发生率和评分。记录两组初乳时间,首次排气时间,住院时间和住院费用。结果两组产妇一般情况、48 h内PCEA镇痛药用量、羟考酮补救镇痛消耗量差异无统计学意义。T组恶心呕吐发生率,寒战发生率明显低于C组(P<0.05)。T组初乳时间、术后首次排气时间和住院时间明显短于C组(P<0.05),住院费用明显少于C组(P<0.05)。结论 TEAS可减少剖宫产产妇恶心呕吐、寒战等常见并发症的发生率及发生程度,有助于产妇早泌乳早排气,缩减住院时间和费用。

Effects of transcutaneous electrical acupoint stimulation on the recovery of body function of cesarean women

Objective To observe the effects of transcutaneous electrical acupoint stimulation(TEAS) on common complications and recovery of body function in puerperae under cesarean section. Methods Eighty uniparas undergoing scheduled cesarean section, aged 22-40 years, with a BMI 18-32 kg/m^2, falling into ASA physical status Ⅰ or Ⅱ, were randomly divided into two groups(n = 40): TEAS combined anesthesia group(group T) and routine anesthesia group(group C), with 40 puerperae in each group. Both groups were treated with the combined spinal and epidural anesthesia and the patient-controlled epidural analgesia(PCEA) after surgery. In group T, transcutaneous electrical acupoint stimulation was performed on Neiguan and Hegu points 30 min before the operation, and continued until the end of the operation. In group C, electrode pads were not applied. The VAS was kept ≤ 3 points after operation. The general situation(maternal age, weight, operation time, bleeding volume, intraoperative fluid infusion volume, etc), the consumption of analgesicsin PCEA and oxycodone for remedy of analgesia within 48 h, the incidence and score of nausea, vomiting and chills, the colostrum time, the first venting time and the hospitalization time and costs were recorded in both groups. Results No significant differences of the two groups in the general situation of the puerperae enrolled and the consumption of analgesics within 48 h were observed. The incidence of nausea, vomiting and chills in group T was significantly lower than that in group C(P < 0.05). The colostrum time, the first venting time, and the hospitalization time in group T were significantly shorter than those in group C(P < 0.05), and the hospitalization cost in group T was significantly less than that in group C(P < 0.05). Conclusion TEAS can abate the incidence and severity of common complications such as nausea, vomiting, and chills in cesarean section. Besides, TEAS contributes to early lactation and early venting of puerperale after cesarean delivery and reduce the hospitalization time and costs.