%0 Journal Article
%T TEAS联合盐酸右美托咪定对肾移植患者术后胃肠功能的影响
%A 袁伟　何平　王瑞　姜伟　景桂霞
%J -
%D 2019
%R 10.13362/j.jpmed.201906006
%X 摘要 目的　探讨经皮穴位电刺激(TEAS)联合盐酸右美托咪定对肾移植术后患者胃肠功能的影响及其可能机制。 方法　将180例肾移植术患者随机分为对照组（A组）、盐酸右美托咪定组（B组）和TEAS联合盐酸右美托咪定组（C组），每组60例。A组给予常规麻醉，B组在手术开始前即按规定流量泵注盐酸右美托咪定直至手术结束，C组除了给予相同剂量的盐酸右美托咪定干预外，TEAS双侧内关、上巨虚和足三里穴持续至手术结束。记录三组患者术后恶心呕吐发生率，首次肠鸣音出现时间，首次排气、排便时间，术后肠麻痹及腹胀腹痛发生率，并比较三组患者术后24 h血清胃泌素(GAS)和血管活性肠肽(VIP)水平。 结果　与A、B组相比，肾移植术后C组患者恶心呕吐发生率明显降低，术后肠鸣音恢复及首次排气排便时间显著缩短，术后肠梗阻及腹胀腹痛发生率明显降低（F=9.53~11.92，P＜0.05）；C组患者手术前后血清中VIP的差值与A、B组比较，差异有显著统计学意义（F=11.19，P＜0.05）。B组患者恶心呕吐发生率、术后肠鸣音恢复时间、首次排气排便时间、术后肠梗阻及腹胀腹痛发生率与A组比较，差异无统计学意义（P＞0.05）。 结论　TEAS能明显降低肾移植术后患者胃肠道并发症发生率，降低胃肠激素VIP的分泌，促进胃肠功能的恢复，而盐酸右美托咪定在促进术后胃肠道功能恢复方面无明显效果。<br>Abstract：Objective　To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) combined with dexmedetomidine hydrochloride on gastrointestinal function after kidney transplantation and the possible mechanism. Methods　A total of 180 patients undergoing kidney transplantation were randomly divided into control group (group A), dexmedetomidine hydrochloride group (group B), and TEAS combined with dexmedetomidine hydrochloride group (group C), with 60 patients in each group. The patients in group A were given routine anesthesia, those in group B were given the pumping of dexmedetomidine hydrochloride at the prescribed rate from before surgery to the end of surgery, and those in group C were given TEAS at Neiguan, Shangjuxu, and Zusanli at both sides until the end of surgery in addition to the treatment in group B. The three groups were compared in terms of the incidence rate of postoperative nausea and vomiting, time to first bowel sound, time to first flatus, time to first defecation, and incidence rates of postoperative enteroparalysis, abdominal distension, and abdominal pain, as well as serum levels of gastrin (GAS) and vasoactive intestinal peptide (VIP) at 24 h after surgery. Results　Compared with groups A and B, group C had a significantly lower incidence rate of postoperative nausea and vomiting, significantly shorter time to first bowel sound, time to first flatus, and time to first defecation, and significantly lower incidence rates of postoperative intestinal obstruction, abdominal distension, and abdominal pain (F=9.53-11.92,P<0.05), as well as a significantly greater change in serum VIP after surgery (F=11.19,P<0.05). There were no significant differences between groups B and A in the incidence rate of postoperative nausea and vomiting, time to first bowel sound, time to first flatus, time to first defecation, and incidence rates of postoperative intestinal obstruction, abdominal distension, and abdominal pain (P>0.05). Conclusion　TEAS can
%K 经皮神经电刺激
%K 穴位
%K 右美托咪啶
%K 麻醉
%K 全身
%K 麻醉
%K 静脉
%K 复合麻醉
%K 肾移植
%K 胃肠活动
%K 胃肠激素类<br>Transcutaneous electric nerve stimulation
%K Points
%K Dexmedetomidine
%K Anesthesia
%K general
%K Anesthesia
%K intravenous
%K Combined anesthesia
%K Kidney transplantation
%K Gastrointestinal motility
%K Gastrointestinal hormones
%U http://jpmed.qdu.edu.cn/CN/10.13362/j.jpmed.201906006