中国中西医结合外科杂志
中國中西醫結閤外科雜誌
중국중서의결합외과잡지
CHINESE JOURNAL OF SURGERY OF INTEGRATED TRADITIONAL AND WESTERN MEDICINE
2015年
3期
267-269
,共3页
罗妙妙%夏燕飞%杨溯威%金鑫
囉妙妙%夏燕飛%楊溯威%金鑫
라묘묘%하연비%양소위%금흠
全身麻醉%经皮穴位电刺激%应激反应%老年患者
全身痳醉%經皮穴位電刺激%應激反應%老年患者
전신마취%경피혈위전자격%응격반응%노년환자
General anesthesia%transcutaneous electrical acupoint stimulation%stress response%aged patients
目的：观察经皮穴位电刺激（TEAS）对老年全身麻醉围术期应激反应和镇痛效果的影响。方法：全麻下行上腹部手术老年患者40例，随机分成对照组和观察组各20例，观察组从麻醉诱导前30 min持续行TEAS，麻醉诱导前(T0)、电刺激30 min（T1）、切皮（T2）、术中探查（T3）、术毕（T4）记录平均动脉血压(MAP)、心率(HR)，采集外周静脉血样测血浆内皮素(ET)、皮质醇(Cor)含量。结果：两组患者T0的MAP、HR、ET、Cor无统计学差异（P＞0.05）；观察组MAP在T2（95.7±14.3）mmHg、T3（96.2±15.4）mmHg、T4（97.8±17.3）mmHg与T0（93.6±14.3）mmHg相比无统计学差异(P＞0.05)，与对照组同期相比下降（P＜0.05）；观察组HR在T2（86±12）次/min、T3（87±15）次/min与T0（75±12）次/min相比有统计学差异(P＞0.05)，与对照组同期相比降低（P＜0.05）；观察组ET在T2（74.2±7.1）ng/L、T3（72.8±8.1）ng/L、T4（69.8±7.6）ng/L与T0（70.9±8.1）ng/L相比无统计学差异(P＞0.05)，与对照组同期相比降低（P＜0.05）；观察组Cor在T2（375.2±93.5）nmol/L、T3（365.1±99.8）nmol/L、T4（370.4±102.5）nmol/L与T0（380.3±107.2）nmol/L相比无统计学差异(P＞0.05)，与对照组同期比较明显降低（P＜0.05）。结论：经皮穴位电刺激能减轻老年全麻围术期应激反应，提供良好的镇痛效果。
目的：觀察經皮穴位電刺激（TEAS）對老年全身痳醉圍術期應激反應和鎮痛效果的影響。方法：全痳下行上腹部手術老年患者40例，隨機分成對照組和觀察組各20例，觀察組從痳醉誘導前30 min持續行TEAS，痳醉誘導前(T0)、電刺激30 min（T1）、切皮（T2）、術中探查（T3）、術畢（T4）記錄平均動脈血壓(MAP)、心率(HR)，採集外週靜脈血樣測血漿內皮素(ET)、皮質醇(Cor)含量。結果：兩組患者T0的MAP、HR、ET、Cor無統計學差異（P＞0.05）；觀察組MAP在T2（95.7±14.3）mmHg、T3（96.2±15.4）mmHg、T4（97.8±17.3）mmHg與T0（93.6±14.3）mmHg相比無統計學差異(P＞0.05)，與對照組同期相比下降（P＜0.05）；觀察組HR在T2（86±12）次/min、T3（87±15）次/min與T0（75±12）次/min相比有統計學差異(P＞0.05)，與對照組同期相比降低（P＜0.05）；觀察組ET在T2（74.2±7.1）ng/L、T3（72.8±8.1）ng/L、T4（69.8±7.6）ng/L與T0（70.9±8.1）ng/L相比無統計學差異(P＞0.05)，與對照組同期相比降低（P＜0.05）；觀察組Cor在T2（375.2±93.5）nmol/L、T3（365.1±99.8）nmol/L、T4（370.4±102.5）nmol/L與T0（380.3±107.2）nmol/L相比無統計學差異(P＞0.05)，與對照組同期比較明顯降低（P＜0.05）。結論：經皮穴位電刺激能減輕老年全痳圍術期應激反應，提供良好的鎮痛效果。
목적：관찰경피혈위전자격（TEAS）대노년전신마취위술기응격반응화진통효과적영향。방법：전마하행상복부수술노년환자40례，수궤분성대조조화관찰조각20례，관찰조종마취유도전30 min지속행TEAS，마취유도전(T0)、전자격30 min（T1）、절피（T2）、술중탐사（T3）、술필（T4）기록평균동맥혈압(MAP)、심솔(HR)，채집외주정맥혈양측혈장내피소(ET)、피질순(Cor)함량。결과：량조환자T0적MAP、HR、ET、Cor무통계학차이（P＞0.05）；관찰조MAP재T2（95.7±14.3）mmHg、T3（96.2±15.4）mmHg、T4（97.8±17.3）mmHg여T0（93.6±14.3）mmHg상비무통계학차이(P＞0.05)，여대조조동기상비하강（P＜0.05）；관찰조HR재T2（86±12）차/min、T3（87±15）차/min여T0（75±12）차/min상비유통계학차이(P＞0.05)，여대조조동기상비강저（P＜0.05）；관찰조ET재T2（74.2±7.1）ng/L、T3（72.8±8.1）ng/L、T4（69.8±7.6）ng/L여T0（70.9±8.1）ng/L상비무통계학차이(P＞0.05)，여대조조동기상비강저（P＜0.05）；관찰조Cor재T2（375.2±93.5）nmol/L、T3（365.1±99.8）nmol/L、T4（370.4±102.5）nmol/L여T0（380.3±107.2）nmol/L상비무통계학차이(P＞0.05)，여대조조동기비교명현강저（P＜0.05）。결론：경피혈위전자격능감경노년전마위술기응격반응，제공량호적진통효과。
Objective To explore the effects of transcutaneous electrical acupoint stimulation(TEAS) on stress response and analgesia in aged patients under general anesthesia. Methods Forty ASA I or II patients undergoing elective operation for upper abdomen were randomly divided into 2 groups (n=20 each): control group and observation group. In observation group electrical stimulation of bilateral Hegu and Zusanli points were started from 30 min before induction of anesthesia and continued until the end of operation. Mean arterial pres?sure(MAP), heart rate(HR), and the contents of plasma endothelin(ET) and cortisol(Cor) were measured before an?esthesia(T0), 30 min before electrical stimulation(T1), after skin incision(T2), during surgical explortion(T3), and at the end of operation(T4). Results The indicators for MAP, HR, plasmic ET and plasmic Cor are not differ?ent at T0 in two groups. In observation group, MAP is (95.7 ± 14.3) mmHg at T2,(96.2 ± 15.4) mmHg. at T3, (97.8±17.3)mmHg at T4. HR is (86±12) beats/min at T2, (87±15) beats/min at T3. Plasmic ET is (74.2±7.1) ng/L at T2,(72.8±8.1)ng/L at T3 and(69.8±7.6)ng/L at T4. The hemodynamic indicators (MAP and HR) are sig?nificantly different betweent two groups at T2 and T3. Similaly, plasmic ET and Cor are very different between two groups at T2 and T3. Comparing to T0, plasmic ET and Cor are not different from those in T2,T3 and T4. Conclusion Transcutaneous electrical acupoint stimulation can reduce the stress response in aged patients under general anesthesia and provide good analgesic effect.
