CAJ | 학술논문

目的：通过观察经皮穴位电刺激（TEAS）辅助硝普钠控制性低血压对血糖（Glu）、血管紧张素Ⅱ（ATⅡ）及超氧化物歧化酶（SOD）的影响，探讨控制性低血压麻醉下 TEAS 对机体的保护作用。方法将择期静吸复合全身麻醉下采用硝普钠控制性降压行鼻内镜手术患者60例，维持平均动脉血压（MAP）在50～60 mm Hg，随机等分为两组，Ⅰ组进行 TEAS，Ⅱ组不进行 TEAS。分别记录两组患者降压时间、手术时间，麻醉前（T0）、降压后30min（T1）、停降压时（T2）3个时点 Glu 和 ATⅡ水平， T0、T2、停降压后30 min（T3）3个时点 SOD 水平。结果两组患者手术时间、控制降压持续时间比较，差异无统计学意义（P ＞0．05）；Glu 水平Ⅰ组 3个时点差异无统计学意义（P ＞0．05），Ⅱ组 T1、T2时点较 T0时点升高（P ＜0．05），T1、T2时点Ⅱ组均比Ⅰ组高（P ＜0．05）；ATⅡ水平Ⅰ组 T1时点较 T0时点升高（P ＜0．05），Ⅱ组 T1、T2时点较 T0时点升高（P ＜0．05），T1、T2时点Ⅱ组均比Ⅰ组高（P ＜0．05）；SOD 水平Ⅰ组 T2时点较 T0时点降低（P ＜0．05），Ⅱ组 T2、T3时点较 T0时点降低（P ＜0．05），T2、T3时点Ⅱ组均比Ⅰ组低（P ＜0．05）。结论TEAS 辅助硝普钠控制性低血压能较好地抑制应激反应。
목적：통과관찰경피혈위전자격（TEAS）보조초보납공제성저혈압대혈당（Glu）、혈관긴장소Ⅱ（ATⅡ）급초양화물기화매（SOD）적영향，탐토공제성저혈압마취하 TEAS 대궤체적보호작용。방법장택기정흡복합전신마취하채용초보납공제성강압행비내경수술환자60례，유지평균동맥혈압（MAP）재50～60 mm Hg，수궤등분위량조，Ⅰ조진행 TEAS，Ⅱ조불진행 TEAS。분별기록량조환자강압시간、수술시간，마취전（T0）、강압후30min（T1）、정강압시（T2）3개시점 Glu 화 ATⅡ수평， T0、T2、정강압후30 min（T3）3개시점 SOD 수평。결과량조환자수술시간、공제강압지속시간비교，차이무통계학의의（P ＞0．05）；Glu 수평Ⅰ조 3개시점차이무통계학의의（P ＞0．05），Ⅱ조 T1、T2시점교 T0시점승고（P ＜0．05），T1、T2시점Ⅱ조균비Ⅰ조고（P ＜0．05）；ATⅡ수평Ⅰ조 T1시점교 T0시점승고（P ＜0．05），Ⅱ조 T1、T2시점교 T0시점승고（P ＜0．05），T1、T2시점Ⅱ조균비Ⅰ조고（P ＜0．05）；SOD 수평Ⅰ조 T2시점교 T0시점강저（P ＜0．05），Ⅱ조 T2、T3시점교 T0시점강저（P ＜0．05），T2、T3시점Ⅱ조균비Ⅰ조저（P ＜0．05）。결론TEAS 보조초보납공제성저혈압능교호지억제응격반응。
Objective To observe the effects of transdermal acupoint electric stimulation(TEAS)assisting sodium nitroprus-side induced controlled hypotension on serum glucose (Glu),angiotensin Ⅱ (ATⅡ)and superoxide dismutase (SOD),and to inves-tigate the protective effect of TEAS under controlled hypotension anesthesia.Methods 60 cases undergoing elective endoscopy si-nus surgery by adopting sodium nitroprusside induced controlled hypotension under general anaesthesia maintained the mean arterial pressure(MAP)in 50-60 mm Hg and were randomly and equally divided into two groups.The group Ⅰ conducted TEAS,while the group Ⅱ did not conduct TEAS.The controlled hypotension time and surgery time were recorded in the two groups;Glu and ATⅡ values were detected before anesthesia (T0 ),30 min after hypotension (T1 ),hypotension stopping(T2 );SOD was detected at T0 ,T2 ,30 min after hypotension(T3 ).Results The operation time and controlled hypotension continuous time had no statistically significant difference between the two groups(P >0.05).The Glu value in the group Ⅰ had no statistically significant difference a-mong the 3 time points,while which at T1 ,T2 was higher than that at T0 in the group Ⅱ(P <0.05),and which at T1 ,T2 in the group Ⅱ was higher than that in the group Ⅰ (P <0.05);the ATⅡ value at T1 was higher than that at T0 in the group Ⅰ (P <0.05),while which at T1 ,T2 was higher than that at T0 in the group Ⅱ(P >0.05),which at T1 ,T2 in the group Ⅱwas higher than that in the group Ⅰ (P <0.05);the SOD value at T2 was lower than that at T0 in the group Ⅰ,which at T2 ,T3 in the group Ⅱwas lower than that in the group Ⅰ(P <0.05).Conclusion TEAS assisting sodium nitroprusside controlled hypotension can better in-hibit the stress response.