CAJ | 학술논문

目的：观察针药复合麻醉对于腹腔镜胆囊切除术患者术前术后脏器功能指标，并进一步探讨其临床和理论意义。方法以60例腹腔镜胆囊切除术患者为研究对象，按随机数字表法分为观察组(针药复合麻醉)、对照组(传统气静复合全身麻醉)，每组30例，观察两组患者术前术后总胆红素、谷丙转氨酶、谷草转氨酶、尿素氮、肌酐及MMSE量表评分，评估针药复合麻醉对于腹腔镜胆囊切除术患者术前术后脏器功能的影响。结果观察组与对照组相比，术前两组总胆红素、谷丙转氨酶、尿素氮、肌酐、MMSE评分比较差异均无统计学意义(P＞0.05)。术前观察组谷草转氨酶水平高于对照组且有统计学意义(P＜0.05)。术后第1天两组肝功能检查谷丙转氨酶及谷草转氨酶水平差异无统计学意义(P＞0.05)。术后第1天观察组总胆红素水平低于对照组且有统计学意义(P＜0.01)。术后第1天两组肾功能检查尿素氮及肌酐水平差异无统计学意义(P＞0.05)。术后6 h观察组MMSE评分高于对照组且差异有统计学意义(P＜0.01)。术后第1天两组脑功能MMSE评分差异无统计学意义(P＞0.05)。结论针药复合麻醉同传统气静复合麻醉在腹腔镜胆囊切除术中的应用对于人体的肝肾功能影响无明显差异。可以认为两种麻醉方式是同样安全有效的。针药复合麻醉对于患者脑功能早期恢复有一定的保护作用，可能对于肝脏功能有一定保护作用。
목적：관찰침약복합마취대우복강경담낭절제술환자술전술후장기공능지표，병진일보탐토기림상화이론의의。방법이60례복강경담낭절제술환자위연구대상，안수궤수자표법분위관찰조(침약복합마취)、대조조(전통기정복합전신마취)，매조30례，관찰량조환자술전술후총담홍소、곡병전안매、곡초전안매、뇨소담、기항급MMSE량표평분，평고침약복합마취대우복강경담낭절제술환자술전술후장기공능적영향。결과관찰조여대조조상비，술전량조총담홍소、곡병전안매、뇨소담、기항、MMSE평분비교차이균무통계학의의(P＞0.05)。술전관찰조곡초전안매수평고우대조조차유통계학의의(P＜0.05)。술후제1천량조간공능검사곡병전안매급곡초전안매수평차이무통계학의의(P＞0.05)。술후제1천관찰조총담홍소수평저우대조조차유통계학의의(P＜0.01)。술후제1천량조신공능검사뇨소담급기항수평차이무통계학의의(P＞0.05)。술후6 h관찰조MMSE평분고우대조조차차이유통계학의의(P＜0.01)。술후제1천량조뇌공능MMSE평분차이무통계학의의(P＞0.05)。결론침약복합마취동전통기정복합마취재복강경담낭절제술중적응용대우인체적간신공능영향무명현차이。가이인위량충마취방식시동양안전유효적。침약복합마취대우환자뇌공능조기회복유일정적보호작용，가능대우간장공능유일정보호작용。
ObjectiveTo observe the effect of combined acupuncture-medication anesthesia on visceral function of patients undergone laparoscopic cholecystectomy, and to furtherexplore its clinical and theoretical significance.MethodSixty patients who were going to receive laparoscopic cholecystectomy were enrolled and randomized into an observation group (combined acupuncture-medication anesthesia) and a control group (conventional general anesthesia) by the random number table, 30 subjects in each group. The total bilirubin (TBIL), alanine aminotransferase (ALT), aspertate aminotransferase (AST), urea nitrogen, creatinine, and Mini-Mental State Examination (MMSE) were observed to evaluate the effect of combined acupuncture-medication anesthesia on visceral function of patients undergone laparoscopic cholecystectomy.ResultBefore operation, there were no significant differences in TBIL, ALT, urea nitrogen, creatinine, and MMSE between the observation group and the control group (P>0.05), while the AST level of the observation group was significantly higher than that of the control group before operation(P<0.05). On post-operation day 1, there were no significant differencesin comparing ALT and AST levels between the two groups (P>0.05); the TBIL level in the observation group was significantly lower than that in the control group (P<0.01); there were no significant differences in comparing the urea nitrogen and creatinine levels between the two groups (P>0.05). The MMSE score of the observation group was significantly higher than that of the control group 6 h after the operation (P<0.01). on post-operation day 1, there was no significant difference in comparing MMSE score between the two groups (P>0.05).ConclusionThe combined acupuncture-medication anesthesia and conventional general anesthesia play equal effects on liver and kidney functions in laparoscopic cholecystectomy, thus the two anesthesia methods are both safe andeffective. The combined acupuncture-medication anesthesia has certain protective effects on brain function in early stage, and possibly produces certain protective effectson liver function.