摘要
目的:观察经皮穴位电刺激(TEAS)辅助全麻与单纯全麻对老年患者腹腔镜胆囊切除术应激反应影响的差异。方法:拟行腹腔镜胆囊切除术患者40例随机分为TEAS辅助全麻组(T组)和单纯全麻组(G组),每组20例。T组采用韩式穴位神经刺激仪电刺激30 min后全麻下实施手术,电刺激持续至手术结束;G组单纯全麻下完成手术。记录麻醉前(T_0)、插管后5 min(T_1)、气腹建立后5 min(T_2)、气腹建立后15 min(T_3)、手术结束(T_4)时平均动脉血压(MAP)、心率(HR)、血氧饱和度(SpO_2)、呼气末二氧化碳分压(PetCO_2)、血浆内皮素(ET)、皮质醇(Cor)含量。记录术中低血压或高血压发生情况。结果:G组患者在气管插管后5 min血液动力学指标较术前下降,幅度大于T组(P<0.05);气腹建立后T组血液动力学指标较术前无显著变化,而G组则逐渐增高,与术前及T组各时点比较差异均有统计学意义(P<0.05,P<0.01)。T组围手术期ET、Cor与麻醉前比较差异无统计学意义(均P>0.05),而G组在建立气腹后逐渐增高,且均高于T组各时点(均P<0.05)。结论:针刺辅助麻醉有利于维持老年人腹腔镜胆囊切除术血液动力学的平稳,减轻CO_2气腹所致的应激反应。
Objective To compare the difference between transcutaneous electrical aeupoint stimulation （TEAS） assisted general anesthesia and simple general anesthesia on stress response during Iaparoscopic eholeeystectomy （LC） in aged patients. Methods Forty patients underwent LC were randomly divided into a TENS assisted general anesthesia group （group T） and a general anesthesia group （group G）, 20 cases in each group. After TEAS for 30 min, general anesthesia was applied in group T, and TEAS was continued until LC over. In group G, only routine general anesthesia was given. Mean arterial pressure （MAP）, heart rate （HR）, saturation of blood oxygen （SpO2）, PetCO2, and the contents of plasma endothelin （ET）, eortisol （Cot） were measured before anesthesia （T0） and after intubation cannula 5 min （T1）, after pneumoperitoneum 5 min （T2） and 15 min （T2）, and LC over （T3）. The rate of hypotension and hypertension were observed during preoperative period. Results The hemodynamics indices decreased in group G at T1 than before. The reductions of MAP and HR in group G were larger than those in group T at T1 （P〈0.05）. After pneumoperitoneum, the hemodynamies indices and serum ET and Cot have no differences in group T as compared with before （all P〉0.05）, but they were all increased more significantly in group G than before, and with significant differences between group G and group T at each time point（P〈0.05, P〈0.01）. Conclusion Acupuncture-assisted anesthesia profit to maintain the hemodynamic stable and reduce the stress response during LC in aged patients.
出处
《中国针灸》
CAS
CSCD
北大核心
2011年第2期155-157,共3页
Chinese Acupuncture & Moxibustion
