世界中西医结合杂志
世界中西醫結閤雜誌
세계중서의결합잡지
World Journal of Integrated Traditional and Western Medicine
2015年
8期
1094-1097,1100
,共5页
容英旋%孙春红%陈荣坚%李经纬%张裕丰%罗哈娜
容英鏇%孫春紅%陳榮堅%李經緯%張裕豐%囉哈娜
용영선%손춘홍%진영견%리경위%장유봉%라합나
单肺通气%肺损伤%电针%足三里
單肺通氣%肺損傷%電針%足三裏
단폐통기%폐손상%전침%족삼리
One - Lung Ventilation%Lung Injury%Electroacupuncture%Zusanli(ST36)
目的：观察电针足三里对开胸手术单肺通气相关肺损伤的作用。方法全身麻醉下行择期开胸手术患者60例（ASA Ⅰ～Ⅱ）随机分为两组，每组30例。麻醉诱导给予同样的药物种类和插管程序。试验组在摆体位后，开始电针足三里直至拔除气管导管。分别于 T1：麻醉前；T2：摆体位调整后气管导管后，电针刺激前；T3：单肺通气30 min 后；T4：恢复双肺通气30 min 后；T5：拔管后10 min；T6：术后24 h；T7：术后3 d 7个时间点观察血流动力学、呼吸力学、血气分析及血清学指标。结果试验组平均动脉压（MAP）在 T3时间点高于对照组，HR 在 T3、T4及 T5时间点均低于对照组（ P ﹤0.05）；试验组 SPO2在 T5时间点，PaO2、氧和指数在 T3～ T6各时间点均大于对照组（P ﹤0.05）。试验组白细胞数在 T6时间点，SP - A 在 T3～ T6各时间点，肿瘤坏死因子-α（TNF -α）在 T4～ T6各时间点，白细胞介素-8（IL -8）在 T4～ T6各时间点均低于对照组（P ﹤0.05）。试验组患者住 ICU 天数短于对照组，术毕3 d 并发症例数显著少于对照组（P ﹤0.05）。结论电针足三里可以减轻开胸手术单肺通气相关的炎症反应，并对该反应所导致的肺损伤有一定的减轻作用。
目的：觀察電針足三裏對開胸手術單肺通氣相關肺損傷的作用。方法全身痳醉下行擇期開胸手術患者60例（ASA Ⅰ～Ⅱ）隨機分為兩組，每組30例。痳醉誘導給予同樣的藥物種類和插管程序。試驗組在襬體位後，開始電針足三裏直至拔除氣管導管。分彆于 T1：痳醉前；T2：襬體位調整後氣管導管後，電針刺激前；T3：單肺通氣30 min 後；T4：恢複雙肺通氣30 min 後；T5：拔管後10 min；T6：術後24 h；T7：術後3 d 7箇時間點觀察血流動力學、呼吸力學、血氣分析及血清學指標。結果試驗組平均動脈壓（MAP）在 T3時間點高于對照組，HR 在 T3、T4及 T5時間點均低于對照組（ P ﹤0.05）；試驗組 SPO2在 T5時間點，PaO2、氧和指數在 T3～ T6各時間點均大于對照組（P ﹤0.05）。試驗組白細胞數在 T6時間點，SP - A 在 T3～ T6各時間點，腫瘤壞死因子-α（TNF -α）在 T4～ T6各時間點，白細胞介素-8（IL -8）在 T4～ T6各時間點均低于對照組（P ﹤0.05）。試驗組患者住 ICU 天數短于對照組，術畢3 d 併髮癥例數顯著少于對照組（P ﹤0.05）。結論電針足三裏可以減輕開胸手術單肺通氣相關的炎癥反應，併對該反應所導緻的肺損傷有一定的減輕作用。
목적：관찰전침족삼리대개흉수술단폐통기상관폐손상적작용。방법전신마취하행택기개흉수술환자60례（ASA Ⅰ～Ⅱ）수궤분위량조，매조30례。마취유도급여동양적약물충류화삽관정서。시험조재파체위후，개시전침족삼리직지발제기관도관。분별우 T1：마취전；T2：파체위조정후기관도관후，전침자격전；T3：단폐통기30 min 후；T4：회복쌍폐통기30 min 후；T5：발관후10 min；T6：술후24 h；T7：술후3 d 7개시간점관찰혈류동역학、호흡역학、혈기분석급혈청학지표。결과시험조평균동맥압（MAP）재 T3시간점고우대조조，HR 재 T3、T4급 T5시간점균저우대조조（ P ﹤0.05）；시험조 SPO2재 T5시간점，PaO2、양화지수재 T3～ T6각시간점균대우대조조（P ﹤0.05）。시험조백세포수재 T6시간점，SP - A 재 T3～ T6각시간점，종류배사인자-α（TNF -α）재 T4～ T6각시간점，백세포개소-8（IL -8）재 T4～ T6각시간점균저우대조조（P ﹤0.05）。시험조환자주 ICU 천수단우대조조，술필3 d 병발증례수현저소우대조조（P ﹤0.05）。결론전침족삼리가이감경개흉수술단폐통기상관적염증반응，병대해반응소도치적폐손상유일정적감경작용。
Objective To observe the effect on lung injury of one - lung ventilation in thoracic sur-gery treated with electroacupuncture(EA)at Zusanli(ST36). Methods Sixty patients with elective thoracic surgery under general anesthesia(ASA Ⅰ to Ⅱ)were randomized into two groups,30 cases in each one. The same drug and intubation was applied to anesthesia induction in the two groups. In the trial group,after posi-tioning,EA at Zusanli(ST36)was given till the tube removal. Separately,before anesthesia(T1 ),after position adjustment and intubation and before EA stimulation(T2 ),30 min after one - lung ventilation(T3 ),30 min after recovery of two - lung ventilation(T4 ),10 min after tube removal(T5 ),24 h after surgery(T6 )and 3 days after surgery(T7 ),the indicators of hemodynamics,breathing mechanics,blood gas analysis and serology were observed. Results In the trial group,MAP was higher than that in the control group at T3 ,HR was low-er than that in the control group at T3 ,T4 and T5(P ﹤ 0. 05). In the trial group,SPO2 at T5 ,PaO2 ,PaO2 / FiO2 at T3 to T6 were all higher than those in the control group(P ﹤ 0. 05). In the trial group,WBC at T6 ,SP - A at T3 to T6 ,TNF - α at T4 to T6 and IL - 8 at T4 to T6 were all lower than those in the control group(P ﹤0. 05). In the trial group,the days in ICU were shorter than that in the control group and the cases of compli-cations in 3 days after surgery were significantly less than those in the control group(P ﹤ 0. 05). Conclusion EA at Zusanli(ST36)alleviates the inflammatory reaction of one - lung ventilation in thoracic surgery as well as lung injury induced by the reaction to a certain extent.
