天津医药

天津医药 ›› 2025, Vol. 53 ›› Issue (2): 189-193.doi: 10.11958/20242049

• 临床研究 • 上一篇    下一篇

经皮耳迷走神经刺激对妇科腹腔镜手术患者术后胃肠功能恢复的影响

刘颖1(), 葛东建2, 朱炫姿1, 向雯1, 耿明悦2, 程伟1,2,3,△()   

  1. 1 徐州医科大学麻醉学院（邮编221004）
    2 南京医科大学附属淮安第一医院麻醉科
    3 徐州医科大学附属医院麻醉科
  • 收稿日期:2024-11-30 修回日期:2024-12-18 出版日期:2025-02-15 发布日期:2025-02-26
  • 通讯作者: △ E-mail: 53974314@qq.com
  • 作者简介:刘颖（1999），女，硕士在读，主要从事经皮耳迷走神经刺激的围术期应用方面研究。E-mail:lyxy2654445447@163.com
  • 基金资助:
    国家自然科学基金资助项目(81200858);江苏省第六期“333高层次人才培养工程”(（2022）3-10-007)

Effect of transcutaneous auricular vagus nerve stimulation on postoperative recovery of gastrointestinal function in patients with gynecological laparoscopic surgery

LIU Ying1(), GE Dongjian2, ZHU Xuanzi1, XIANG Wen1, GENG Mingyue2, CHENG Wei1,2,3,△()   

  1. 1 School of Anesthesiology, Xuzhou Medical University, Xuzhou 221004, China
    2 Department of Anesthesiology, the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University
    3 Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University
  • Received:2024-11-30 Revised:2024-12-18 Published:2025-02-15 Online:2025-02-26
  • Contact: △ E-mail: 53974314@qq.com

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摘要：

目的 探讨经皮耳迷走神经刺激（taVNS）对妇科腹腔镜手术患者术后胃肠功能恢复的影响。方法 选取择期行腹腔镜全子宫切除术患者96例，按随机数字表法分为taVNS组（T组）和假刺激组（F组）各48例。2组均采用常规全身麻醉方案，T组于术前及麻醉恢复室各接受1次taVNS，每次刺激30 min，而F组各接受假刺激30 min。记录术后排气、排便恢复时间，术后第1、2、3天的进食-恶心-呕吐-查体-症状持续时间评分（I-FEED），术后3 d的胃肠道症状评定量表（GSRS）。记录术后第1、2天的疼痛数字评分（NRS），术后补救镇痛情况，术后不良反应发生情况和术后住院时间。结果 与F组相比，T组术后首次排气、排便时间明显缩短，术后第1、2、3天的I-FEED评分和术后3 d的GSRS评分明显降低，术后胃肠道不耐受和术后胃肠功能障碍患者比例降低（P<0.05）；术后第1、2天的NRS降低，术后恶心发生率降低（P<0.05）。2组患者术后补救镇痛情况、术后呕吐、头晕、心动过缓、低血压发生率和术后住院时间差异无统计学意义（P>0.05）。结论 taVNS能改善腹腔镜全子宫切除患者术后胃肠功能恢复情况，减轻术后恶心，缓解术后疼痛。

关键词: 经皮神经电刺激, 迷走神经刺激术, 腹腔镜检查, 妇科手术, 术后胃肠功能

Abstract:

Objective To explore the effect of transcutaneous auricular vagus nerve stimulation (taVNS) on postoperative recovery of gastrointestinal function in gynecological laparoscopic surgery patients. Methods Ninety-six patients who underwent elective laparoscopic total hysterectomy were selected. According to the random number table method, patients were divided into the taVNS group (group T) and the sham stimulation group (group F) with 48 patients in each group. The conventional general anesthesia method was used in both groups. The group T received taVNS once before surgery and once in the anaesthesia recovery room with 30 min per stimulation, while the group F was given sham stimulation for 30 min each. Postoperative recovery time of anal gas and defecation, the I-FEED scores on the 1st, 2nd and 3rd postoperative days, the GSRS score on the 3rd postoperative day were recorded. The NRS scores on the 1st and 2nd postoperative days, postoperative remedial analgesia, occurrence of postoperative adverse effects and duration of postoperative hospitalization were recorded. Results Compared with the group F, the time to first postoperative anal exhaust and defecation was significantly shorter in the group T. The I-FEED scores on the 1st, 2nd and 3rd postoperative days, and the GSRS score on 3rd postoperative day were significantly decreased in the group T. The proportion of patients with postoperative gastrointestinal intolerance and postoperative gastrointestinal dysfunction were reduced in the group T (P<0.05). NRS scores at postoperative days 1, and 2 were decreased and the incidence of postoperative nausea was lower (P<0.05). There were no significant differences in postoperative remedial analgesia, the occurrence of postoperative vomiting, dizziness, bradycardia and hypotension, and duration of postoperative hospitalization in the two groups of patients (P>0.05). Conclusion taVNS can improve the recovery of postoperative gastrointestinal function, reduce postoperative nausea and alleviate postoperative pain in laparoscopic total hysterectomy patients.

Key words: transcutaneous electric nerve stimulation, vagus nerve stimulation, laparoscopy, gynecological surgery, postoperative gastrointestinal function

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