双侧内关穴、合谷穴经皮穴位电刺激预防甲状腺切除术后恶心呕吐的效果

Effect of transcutaneous acupoint electrical stimulation at bilateral Neiguan and Hegu acupoints on preventing postoperative nausea and vomiting after thyroidectomy

中文关键词: 经皮穴位电刺激  甲状腺切除术  术后恶心呕吐  内关穴  合谷穴

英文关键词: Transcutaneous acupoint electrical stimulation  Thyroidectomy  Postoperative nausea and vomiting  Neiguan acupoint  Hegu acupoint

中文摘要:

      
目的 探讨经皮穴位电刺激（TAES）对甲状腺切除患者术后恶心呕吐的预防效果。
方法 选择2019年6—11月择期行甲状腺切除术女性患者80例，年龄25～60岁，BMI 18～30 kg/m²，ASA Ⅰ或Ⅱ级。采用随机数字表将患者分为两组：经皮穴位电刺激组（E组）和对照组（C组），每组40例。麻醉诱导前30 min E组行双侧内关穴、合谷穴TAES；手术结束前30 min C组静脉注射格拉司琼3 mg。记录术后30 min和术后6、12、24 h恶心、呕吐例数及严重程度。术后12 h每组随机选择15例患者检测血浆5-羟色胺（5-HT）浓度。
结果 与C组比较，术后12、24 h E组恶心发生率和严重程度明显降低（P<0.05），术后6、12、24 h E组呕吐发生率和严重程度明显降低（P<0.05），术后12 h血浆5-HT浓度明显降低（P<0.05）。术后30 min两组恶心、呕吐发生率和严重程度差异无统计学意义。
结论 双侧内关穴、合谷穴经皮穴位电刺激应用于甲状腺切除术后，可以降低血浆5-HT浓度，有效预防甲状腺手术后恶心、呕吐。

英文摘要:

      
Objective To investigate the effect of transcutaneous acupoint electrical stimulation (TAES) for preventing postoperative nausea and vomiting after thyroidectomy.
Methods Eighty female patients underwent selective thyroidectomy from June 2019 to November 2019, aged 25-60 years, BMI 18-30 kg/m², ASA physical status Ⅰ or Ⅱ, were randomly allocated into two groups: TAES group (group E) and control group (group C), 40 patients in each group. TAES at bilateral Neiguan and Hegu acupoints was operated 30 minutes before induction of anesthesia in group E. Granisetron 3 mg was given 30 minutes before the end of thyroidectomy in group C. The incidence and severity of postoperative nausea and vomiting 30 minutes, 6, 12, and 24 hours after the operation were recorded. Fifteen patients in each group were chosen randomly to determine the concentration of plasma 5-hydroxytryptamine (5-HT) 12 hours after operation.
Results Compared with group C, the incidence and severity of nausea 12 and 24 hours after operation were significantly reduced in group E (P < 0.05), the incidence and severity of vomiting 6, 12 and 24 hours after operation were significantly decreased in group E (P < 0.05), and the concentration of plasma 5-HT 12 hours after operation was significantly decreased in group E (P < 0.05). There were no significant differences in the incidence and severity of postoperative nausea and vomiting 30 minutes after operation between groups E and C.
Conclusion Transcutaneous acupoint electrical stimulation at bilateral Neiguan and Hegu acupoints after thyroidectomy can reduce the concentration of plasma 5-HT, and prevent postoperative nausea and vomiting effectively.