摘要
肾移植术后恶心呕吐（PONV）是影响患者恢复质量的常见并发症，而以药物为主的防治策略在这一特殊人群中常面临安全性与有效性的双重制约。经皮穴位电刺激（TEAS）作为一种非侵入性物理疗法，在围术期PONV防治中展现出独特优势。本文围绕TEAS防治PONV的主要机制展开评述，包括内源性阿片肽释放、自主神经平衡调节、胃肠激素调控以及抗炎通路等多靶点协同作用，并结合肾移植患者特殊的病理生理背景，分析该技术在肾移植领域临床应用的研究现状与不足。现有证据虽初步提示TEAS可降低肾移植患者PONV发生率并促进胃肠功能恢复，但相关研究在样本量、设计质量和机制深度上仍存在明显局限。据此，本文提出未来应重点推进多中心高质量临床试验、开展肾移植特异性机制研究、建立标准化操作规范，并探索遗传背景对疗效的调控作用，以期为将该技术整合入肾移植围术期加速康复外科体系提供参考。
关键词： 经皮穴位电刺激；肾移植；术后恶心呕吐；加速康复外科
Abstract
Postoperative nausea and vomiting (PONV) remains a common complication after kidney transplantation that impairs recovery quality, while pharmacologically based prophylaxis and treatment often face dual constraints of safety and efficacy in this specific population. Transcutaneous electrical acupoint stimulation (TEAS), a non-invasive physical therapy, has shown unique advantages in perioperative PONV management. This review focuses on the main mechanisms by which TEAS alleviates PONV, including endogenous opioid peptide release, autonomic nervous balance regulation, gastrointestinal hormone modulation, and anti-inflammatory pathways, and discusses the current status and limitations of its clinical application in kidney transplantation, taking into account the special pathophysiological background of kidney transplant recipients. Preliminary findings suggest a potential benefit of TEAS in reducing PONV and improving gastrointestinal recovery among kidney transplant recipients; however, current studies suffer from limited sample sizes, methodological weaknesses, and insufficient mechanistic exploration. Therefore, we propose that future research should emphasize large-scale, multi-center trials, kidney transplant-specific mechanistic investigations, standardized treatment protocols, and assessment of genetic factors that may modulate therapeutic outcomes, ultimately supporting the integration of TEAS into ERAS programs for kidney transplantation.
Key words： Transcutaneous electrical acupoint stimulation; Kidney transplantation; Postoperative nausea and vomiting; Enhanced recovery after surgery
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