经皮穴位电刺激对老年患者全髋关节置换术后排尿功能的影响

涂育铭; 曲善艟; 林舜艳; 辜淑靖; 高巨

doi:10.13703/j.0255-2930.20230302-k0005

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经皮穴位电刺激对老年患者全髋关节置换术后排尿功能的影响

临床研究 | 更新时间：2024-06-03

- 经皮穴位电刺激对老年患者全髋关节置换术后排尿功能的影响
- Effect of transcutaneous electrical acupoint stimulation on postoperative urinary function in elderly patients undergoing total hip arthroplasty
- 中国针灸 2024年44卷第4期页码：395-399
- 作者机构：
  
  1.徐州医科大学，江苏徐州 221000；江苏省苏北人民医院
  2.关节外科
  3.麻醉科，扬州 225000
  4.贵州医科大学麻醉学院
- 作者简介：
  
  高巨，教授、主任医师。E-mail：gaoju_003@163.com
- 基金信息：
  
  江苏省卫生健康委员会医学科研项目面上项目：2021-166号
- DOI：10.13703/j.0255-2930.20230302-k0005
  中图分类号：
- 收稿：2023-03-02，
  
  网络首发：2024-01-18，
  
  纸质出版：2024-04-12
- 稿件说明：
移动端阅览
涂育铭,曲善艟,林舜艳,等.经皮穴位电刺激对老年患者全髋关节置换术后排尿功能的影响[J].中国针灸,2024,44(4):395-399.

TU Yuming,QU Shanchong,LIN Shunyan,et al.Effect of transcutaneous electrical acupoint stimulation on postoperative urinary function in elderly patients undergoing total hip arthroplasty[J].Chinese Acupuncture & Moxibustion,2024,44(04):395-399.
涂育铭,曲善艟,林舜艳,等.经皮穴位电刺激对老年患者全髋关节置换术后排尿功能的影响[J].中国针灸,2024,44(4):395-399. DOI： 10.13703/j.0255-2930.20230302-k0005.

TU Yuming,QU Shanchong,LIN Shunyan,et al.Effect of transcutaneous electrical acupoint stimulation on postoperative urinary function in elderly patients undergoing total hip arthroplasty[J].Chinese Acupuncture & Moxibustion,2024,44(04):395-399. DOI： 10.13703/j.0255-2930.20230302-k0005.

摘要

目的

观察经皮穴位电刺激（TEAS）对老年患者全髋关节置换术（THA）后排尿功能的影响。

方法

将180例行单侧全髋关节置换术且未留置导尿管的老年患者随机分为TEAS组（90例，脱落3例，剔除4例）和假TEAS组（90例，脱落1例，剔除4例）。两组均采用超声引导下髂筋膜阻滞联合蛛网膜下隙阻滞麻醉。TEAS组于麻醉开始前30 min于中极、关元及双侧会阳、次髎行TEAS干预，疏密波，频率2 Hz/100 Hz，至术后30 min；假TEAS组于相同穴位连接装置但不通电。观察两组患者术后尿潴留（POUR）发生率、首次排尿时间、排尿阈值、尿三磷酸腺苷（ATP）含量、术后异常排尿状态（膀胱残余尿量、再导尿率、夜尿发生率）及术后尿路感染（UTI）、假体周围感染（PJI）发生率。

结果

TEAS组POUR发生率低于假TEAS组（

0.05），首次排尿时间短于假TEAS组（

0.05），排尿阈值低于假TEAS组（

0.05），尿ATP含量高于假TEAS组（

0.05），膀胱残余尿量少于假TEAS组（

0.05），夜尿发生率低于假TEAS组（

0.05）。两组患者再导尿率、UTI发生率、PJI发生率比较差异无统计学意义（

0.05）。

结论

经皮穴位电刺激可有效减少老年患者全髋关节置换术后尿潴留的发生，改善其术后排尿功能，其机制可能与提高患者尿ATP含量有关。

Abstract

Objective

To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) on postoperative urinary function in elderly patients undergoing total hip arthroplasty (THA).

Methods

One hundred and eighty elderly patients undergoing unilateral THA without indwelling urinary catheters were randomly assigned to a TEAS group (90 cases

3 cases dropped out

4 cases were eliminated) and a sham TEAS group (90 cases

1 case dropped out

4 cases were eliminated). Both groups received fascia iliac block and subarachnoid block anesthesia under ultrasound guidance. The patients in the TEAS group were treated with TEAS at Zhongji (CV 3)

Guanyuan (CV 4)

and bilateral Huiyang (BL 35)

Ciliao (BL 32) 30 minutes before anesthesia initiation

with dissperse-dense wave

frequency of 2 Hz/100 Hz

until 30 minutes after surgery. The patients in the sham TEAS group underwent the same procedure with the device applied at the same acupoints but without electrical stimulation. The incidence of postoperative urinary retention (POUR)

time to first void

voiding threshold

urinary adenosine triphosphate (ATP) level

postoperative abnormal voiding status (bladder residual volume

re-catheterization rate

nocturia occurrence)

and postoperative incidence of urinary tract infection (UTI) and prosthetic joint infection (PJI) were observed in both groups.

Results

The incidence of POUR in the TEAS group was lower than that in the sham TEAS group (

0.05); the time to first void in the TEAS group was shorter than that in the sham TEAS group (

0.05); the voiding threshold in the TEAS group was lower than that in the sham TEAS group (

0.05); the urinary ATP level in the TEAS group was higher than that in the sham TEAS group (

0.05); the bladder residual volume in the TEAS group was lower than that in the sham TEAS group (

0.05); the nocturia occurrence in the TEAS group was lower than that in the sham TEAS group (

0.05). However

there was no statistically significant difference in re-catheterization rate

incidence of UTI

and incidence of PJI between the two groups (

0.05).

Conclusion

TEAS could effectively reduce the occurrence of postoperative urinary retention and improve the postoperative urinary function in elderly patients undergoing THA

which might be related with increasing the urinary ATP level.

关键词

Keywords

references

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