围手术期经皮穴位电刺激对结直肠肿瘤患者术后胃肠功能影响的Meta分析

doi:10.3761/j.issn.2096-7446.2023.03.004

摘要/Abstract

摘要： 目的了解围手术期经皮穴位电刺激对结直肠肿瘤患者术后胃肠功能恢复的影响。方法计算机检索PubMed、Embase、The Cochrane Library、Web of Science、中国生物医学文献数据库、万方数据知识服务平台、中国知网、维普数据库,收集关于结直肠肿瘤患者围手术期经皮穴位电刺激对术后胃肠功能恢复影响的随机对照试验研究,检索时限为建库至2022年6月。由2名接受过循证护理培训的研究者根据纳入排除标准独立筛查文献、提取资料、质量评价后使用Stata 14.0软件进行Meta分析。结果最终纳入14篇文献,共1 560例患者。结果显示,围手术期经皮穴位电刺激可缩短肠鸣音恢复时间[WMD=-9.58,95%CI（-12.30,-6.88）,Z=6.94,P<0.001],缩短首次肛门排气时间[WMD=-12.35,95%CI（-15.58, -9.12）,Z=7.49,P<0.001],降低恶心呕吐发生率[RR=0.46,95%CI（0.32,0.66）,Z=4.18,P<0.001],加快首次排便时间[WMD=-15.51,95%CI（-22.16,-8.86）,Z=4.57,P<0.001],缩短住院天数[WMD=-1.64,95%CI（-2.75,-0.54）,Z=2.92,P=0.004]。但在肠梗阻发生率上差异无统计学意义[RR=0.62,95%CI（0.26,1.45）,Z=1.11,P=0.27]。结论围手术期经皮穴位电刺激有助于结直肠肿瘤患者术后胃肠功能恢复,但在选穴、干预时机、频率、经皮穴位电刺激仪器参数的选择上尚未形成共识,需要开展进一步高质量的临床研究进行验证。

关键词: 围手术期, 结直肠肿瘤, 经皮穴位电刺激, 胃肠功能, Meta分析

Abstract: Objective To investigate the effect of perioperative transcutaneous electrical acupoint stimulation on postoperative gastrointestinal function in patients with colorectal cancer by meta-analysis. Methods PubMed,Embase,the Cochrane Library,Web of Science,China Biomedical Literature Database,Wanfang Data Knowledge Service Platform,China National Knowledge Infrastructure,VIP database were electronically searched to collect randomized control trials on the effects of perioperative transcutaneous electrical acupoint stimulation on postoperative gastrointestinal function recovery in colorectal surgery patients from inception of database to June 2022. Two reviewers with evidence-based nursing training independently screened the literature according to the inclusion and exclusion criteria,extracted data,and evaluated the quality, and then performed meta-analysis by Stata14.0 software. Results A total of 14 literature were included,involving 1 560 patients.The results showed that transcutaneous electrical acupoint stimulation could accelerate the recovery of bowel sounds[WMD=-9.58,95%CI（-12.30,-6.88）,Z=6.94,P<0.001] and shorten the time of anal exhaust[WMD=-12.35,95%CI（-15.58,-9.12）,Z=7.49,P<0.001],reduce the incidence of nausea and vomiting[RR=0.46,95%CI（0.32,0.66）,Z=4.18,P<0.001],accelerate the time of first defecation[WMD= -15.51,95%CI（-22.16,-8.86）,Z=4.57,P<0.001],shorten hospitalization days[WMD=-1.64,95%CI（-2.75,-0.54）,Z=2.92,P=0.004]. However,there was no significant difference in the incidence of intestinal obstruction[RR=0.62,95%CI（0.26,1.45）,Z=1.11,P=0.27]. Conclusion Transcutaneous electrical acupoint stimulation can promote the recovery of gastrointestinal function in patients with colorectal cancer after surgery. However,there is no consensus on the selection of acupoints,intervention timing,frequency,and the selection of parameters of transcutaneous electrical acupoint stimulation instrument,which needs to be validated by further high-quality clinical studies.

Key words: Perioperative Period, Colorectal Neoplasms, Transcutaneous Electrical Acupoint Stimulation, Gastrointestinal Function, Meta-Analysis

陈佳萍, 李鹤, 卞丽芳, 施晓兰, 李琰. 围手术期经皮穴位电刺激对结直肠肿瘤患者术后胃肠功能影响的Meta分析[J]. 中华急危重症护理杂志, 2023, 4(3): 213-221.

CHEN Jiaping, LI He, BIAN Lifang, SHI Xiaolan, LI Yan. Effect of perioperative transcutaneous electrical acupoint stimulation on postoperative gastrointestinal function in patients with colorectal cancer：a Meta-analysis[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023, 4(3): 213-221.

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