经皮穴位电刺激对老年髋部骨折病人术后疼痛管理及胃肠功能恢复的影响

doi:10.3969/j.issn.1003-9198.2025.09.010

摘要/Abstract

摘要： 目的探讨经皮穴位电刺激对行人工髋关节置换术的老年髋部骨折病人术后疼痛管理及胃肠功能恢复的综合疗效。方法在2023年6月至2024年6月期间,选取南通市中医院接收的90例老年髋部骨折病人作为研究对象。采用随机数表法,分为对照组(n=45,接受常规术后镇痛)和观察组(n=45,在对照组基础上接受经皮穴位电刺激)。比较2组间手术相关指征(手术时间、术中出血量、首次排便时间、首次排气时间和首次进食时间),术后1、2、3 d的恶心和呕吐评分,胃肠道激素[胃动素 (MOT)、胃泌素 (G-17)、胆囊收缩素 (CCK)]水平以及术后1、2、3 d VAS评分的差异。结果观察组首次排便时间、排气时间、进食时间均短于对照组(P＜0.05)。观察组术后1、2、3 d恶心呕吐评分量表的评分均低于对照组(P＜0.05)。观察组术后1、2、3 d血清MOT、G-17水平均高于对照组,CCK水平低于对照组(P＜0.05)。2组病人术后1、2、3 d的VAS评分差异无统计学意义(P＞0.05)。观察组的不良事件发生率与对照组比较,差异无统计学意义(P＞0.05)。结论经皮穴位电刺激可显著改善老年髋部骨折病人术后的胃肠功能,降低术后并发症发生率,治疗安全,值得临床推广应用。

关键词: 老年人, 髋部骨折, 经皮穴位电刺激, 疼痛管理, 胃肠功能恢复, 术后并发症

Abstract: Objective To explore the comprehensive efficacy of transcutaneous electrical acupoint stimulation (TEAS) in managing postoperative pain and improving gastrointestinal recovery in the elderly patients with hip fractures. Methods A total of 90 elderly patients with hip fractures undergoing artificial hip replacement at Nantong Hospital of Traditional Chinese Medicine from June 2023 to June 2024 were enrolled in this study. They were randomly divided into control group (n=45, receiving conventional postoperative analgesia) and observation group (n=45, receiving TEAS in addition to conventional analgesia). Surgery-related indicators (operation time, intraoperative blood loss, time to first defecation, time to first flatus and time to first oral intake), nausea and vomiting scores 1, 2, and 3 d after operation, gastrointestinal hormone levels [motilin (MOT), gastrin (G-17), and cholecystokinin (CCK)], and pain visual analog scale (VAS) score 1, 2, and 3 d after operation were compared between the two groups. Results Compared with the control group, the time to first defecation, time to first flatus, and time to first oral intake were significantly shorter, the nausea and vomiting scores 1, 2, and 3 d after operation were significantly lower, and the serum levels of MOT and G-17 were significantly higher, while the level of CCK was significantly lower 1, 2, and 3 d after operation in the observation group (all P<0.05). No significant differences were observed in VAS scores 1, 2, and 3 d after operation and the incidence rate of adverse events between the two groups (P> 0.05). Conclusions TEAS could significantly improve gastrointestinal function and reduce the incidence of postoperative complications in the elderly patients with hip fractures. The treatment is safe and worthy for clinical promotion.

Key words: aged, hip fracture, transcutaneous electrical acupoint stimulation, pain management, gastrointestinal function recovery, postoperative complication

中图分类号:

R 246

黄涌, 王锋锋, 石伯生, 黄丽, 王志飞. 经皮穴位电刺激对老年髋部骨折病人术后疼痛管理及胃肠功能恢复的影响[J]. 实用老年医学, 2025, 39(9): 910-914.

HUANG Yong, WANG Fengfeng, SHI Bosheng, HUANG Li, WANG Zhifei. Transcutaneous acupoint electrical stimulation for postoperative pain management and gastrointestinal function recovery in elderly patients with hip fractures[J]. Practical Geriatrics, 2025, 39(9): 910-914.

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