作者：马婵珊，张兰艳

单位：汕头大学医学院第一附属医院 胃肠外科，广东 汕头 515000

Authors: Ma Chanshan，Zhang Lanyan

Unit: Department of Gastrointestinal Surgery, the First Affiliated Hospital of Shantou University Medical College, Shantou 515000, Guangdong, China

摘要：

目的 回顾性分析经皮穴位电刺激(transcutaneous electrical acupoint stimulation,TEAS在腹腔镜结直肠手术后切口镇痛中的作用,以及对患者生命体征、护理满意度的影响。方法 从电子病历系统采集患者信息,以TEAS的临床使用时间为节点,将患者分为TEAS组及对照组,收集的信息包括患者基本资料、初步诊断、生命体征、手术信息、麻醉方式、多模式镇痛方式、患者满意度。结果 TEAS组的疼痛评分低于对照组(P<0.05),两组患者手术前后生命体征的变化差异无统计学意义(P>0.05),TEAS组的护理满意度评分高于对照组(P<0.05)。结论 在腹腔镜结直肠癌手术的加速康复外科管理流程中,TEAS可作为缓解术后疼痛的有效方法,能带来护理满意度的提高,不会对患者的生命体征产生不良影响。TEAS可以作为药物治疗之外的辅助手段,用以缓解术后疼痛,应当开展针对TEAS应用的护理培训计划。

关键词：经皮穴位电刺激；加速康复外科；腹腔镜；结直肠手术

Abstract：

Objective This retrospective cohort study was conducted to analysis the effect of transcutaneous electrical acupoint stimulation (TEAS) as a part of enhanced recovery after surgery (ERAS) program on postoperative pain, changes in patient’s vital signs, and patient satisfaction after laparoscopic colorectal surgery. Methods The data were retrived from the electronic medical record system. Patients were divided into the TEAS group and control group according to the time point of initiating TEAS application. The data collected included basic demographic records, initial diagnosis, vital signs, surgical records, anesthetic approach, multimodal analgesia modality and patient satisfaction. Results Pain scores of patients in the TEAS group were lower than those in the control group (P<0.05). No differences were found in pre-and post-surgery regarding the vital signs in both groups. Satisfaction scores were higher in the TEAS group than control group (P<0.05). Conclusions TEAS was a useful method to reduce postoperative pain, and patient satisfaction with nursing care increased without any negative effect on vital signs in patients undergoing laparoscopic colorectal surgery following the ERAS program. TEAS should be used as an adjunct to pharmacologic methods to reduce postoperative pain. In -service training programs for TEAS application should be organized for nurses.

Key Words: Transcutaneous electrical acupoint stimulation；Enhanced recovery after surgery；Laparoscopic；Colorectal surgery