目的 探讨经皮耳迷走神经电刺激（taVNS）对腹腔镜肝胆外科手术患者术后胃肠功能恢复的影响。 方法 选取择期行腹腔镜肝胆外科手术的患者170例，随机分配至taVNS组（n = 85）和对照组（n = 85）。分别于术前1 d、诱导前30 min、术后入恢复室各接受1次刺激或假刺激，每次刺激30 min。记录患者术后首次排气、排便时间，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48 h恶心呕吐发生率，术后拔管即刻及术后第1、2、3天的疼痛数字评分（NRS），术后第1、2、3天的阿森斯失眠量表（AIS）和焦虑抑郁量表（HADS），术后早期恢复质量（QoR-15），术后不良反应发生情况等。 结果 与对照组相比，taVNS组术后首次排气、排便时间明显缩短，术后I-FEED评分降低，拔除气管导管即刻及术后第1天的NRS评分降低，术后48 h恶心呕吐发生率降低，术后第1天的QoR-15评分提升（P < 0.05）。两组术后AIS评分和HADS评分差异无统计学意义（P > 0.05）。 结论 taVNS可改善腹腔镜肝胆外科手术患者术后胃肠功能恢复情况，减轻术后恶心、呕吐，缓解术后疼痛，并促进术后恢复。

Objective To investigate the impact of transcutaneous auricular vagus nerve stimulation （taVNS） on the postoperative recovery of the gastrointestinal system in patients who have undergone laparoscopic hepatobiliary surgery. Methods A total of 170 patients undergoing elective laparoscopic hepatobiliary surgery were randomly allocated to the taVNS group （n = 85） and the control group （n = 85）. Participants received three consecutive 30-minute sessions of active stimulation or sham stimulation at three time points： （1） one day before the operation， （2） 30 minutes before induction， and （3） upon arrival at the recovery room after the operation. The following parameters were recorded： the time to the first postoperative flatus and bowel movement； Intake-Nausea-Emesis-Examination-Duration （I-FEED） scores on the first， second， and third postoperative days； the incidence of nausea and vomiting within 48 hours after the operation； the pain numerical rating scale （NRS） immediately after extubation and on the first， second， and third postoperative days； the Athens Insomnia Scale （AIS） and the Hospital Anxiety and Depression Scale （HADS） on the first， second， and third postoperative days； the early postoperative quality of recovery （QoR-15）， and the occurrence of postoperative adverse reactions. Results Compared with the control group， the taVNS group exhibited significantly shorter durations until the first postoperative flatus and bowel movement， a reduction in postoperative I-FEED scores， lower NRS scores immediately after extubation and on postoperative day 1， a decreased incidence of postoperative nausea and vomiting at 48 hours， and an improvement in QoR-15 scores on postoperative day 1 （P < 0.05）. No statistically significant differences were detected between the groups in postoperative AIS scores or HADS scores （P > 0.05）. Conclusion TaVNS enhances postoperative gastrointestinal recovery in patients undergoing laparoscopic hepatobiliary surgery， mitigates postoperative nausea and vomiting， alleviates postoperative pain， and facilitates recovery.