经皮穴位电刺激预防全麻导尿患者膀胱刺激征的临床随机对照研究

A Randomized Controlled Trial of Transcutaneous Electrical Acupoint Stimulation (TEAS) for the Prevention of Catheter-Related Bladder Discomfort in Anesthetized Patients with Urinary Catheter

摘要: 目的：本研究旨在探讨经皮穴位电刺激(Transcutaneous Electrical Acupoint Stimulation, TEAS)在预防全身麻醉(全麻)下留置导尿男性患者术后膀胱刺激征(Catheter-Related Bladder discomfort, CRBD)方面的效果。方法：研究对象为2024年6月至11月期间接受择期手术的60名符合条件的男性患者，将其随机分为两组：TEAS组(30例)和CON组(30例)即对照组。在全麻诱导前30分钟，TEAS组在关元、中极、足三里、三阴交穴位粘贴电极片并接受电刺激，CON组不做任何干预。记录拔除气管导管即刻(T1)、拔管后0.5小时(T2)和术后2小时(T3)的CRBD发生情况、严重程度、伤口疼痛程度、恶心呕吐及躁动情况。结果：TEAS组在T1时刻的CRBD发生率显著低于CON组(χ² = 6.29, P < 0.05)，躁动发生率显著低于CON组(χ² = 6.36, P < 0.05)，均具有统计学差异。术后两组在伤口疼痛程度、恶心呕吐、谵妄嗜睡方面差异无显著统计学意义。结论：本研究初步表明TEAS可能在拔管即刻对预防CRBD有效，但其确切疗效和作用持久性仍需进一步探索。

Abstract: Objective: This study aims to investigate the efficacy of Transcutaneous Electrical Acupoint Stimulation (TEAS) in preventing the occurrence of Catheter-Related Bladder Discomfort (CRBD) in male patients undergoing urinary catheterization under general anesthesia. Methods: A total of 60 eligible male patients scheduled for elective surgery between June and November 2024 were enrolled and randomly assigned to two groups: the TEAS group (n = 30) and the CON group (n = 30), which served as the control. Thirty minutes before the induction of general anesthesia, electrode pads were applied to the acupoints Guanyuan (CV4), Zhongji (CV3), Zusanli (ST36), and Sanyinjiao (SP6) in the TEAS group for electrical stimulation, whereas the CON group received no intervention. The incidence and severity of CRBD, incisional pain, nausea and vomiting, and agitation were recorded at the following time points: immediately after tracheal extubation (T1), 0.5 hours after extubation (T2), and 2 hours postoperatively (T3). Results: At the T1 time point (immediately after extubation), the TEAS group demonstrated a significantly lower incidence of CRBD (χ² = 6.29, P < 0.05) and a significantly lower incidence of agitation (χ² = 6.36, P < 0.05) compared to the CON group. However, no statistically significant differences were observed between the two groups in terms of incisional pain, nausea and vomiting, delirium, or sedation during the postoperative period. Conclusion: This preliminary study suggests that TEAS may be effective in mitigating CRBD immediately following tracheal extubation. Nevertheless, its definitive efficacy and duration of action require further investigation.