摘要
目的:探究经皮穴位电刺激在老年骨科全麻患者中的应用效果及对氧代谢、认知状态的影响。方法:将2021年2月—2024年4月徐州市中医院的80例老年骨科全麻患者根据随机数字表法分为对照组与观察组。对照组(n=40)进行常规全麻干预,观察组(n=40)则在对照组的基础上于麻醉诱导前进行经皮穴位电刺激。比较两组的应答时间、气管导管拔除时间、麻醉恢复室(PACU)停留时间、术后不同时间的疼痛情况(VAS评分)、认知障碍发生率、围手术期的血流动力学(MAP、HR)、氧代谢状态[动脉-静脉血氧含量差(Da-jvO2)、氧摄取率(CERO2)]及认知状态指标[血清S100钙结合蛋白B(S100B)、神经生长因子(NGF)]。结果:观察组的应答时间、气管导管拔除时间及PACU停留时间均显著短于对照组,术后12、24 h的VAS评分显著低于对照组,术后1、3 d的认知障碍发生率显著低于对照组,差异有统计学意义(P<0.05)。术前两组的血流动力学指标、氧代谢状态及认知状态指标比较,差异无统计学意义(P>0.05);术中30 min及术后即刻,观察组的血流动力学及氧代谢状态指标显著低于对照组,术后1、3 d的认知状态指标显著低于对照组,差异有统计学意义(P<0.05)。结论:经皮穴位电刺激在老年骨科全麻患者中的应用效果较好,有助于促进患者的术后恢复,且对氧代谢及认知状态的影响更积极。
Objective:To investigate the application effect of transcutaneous electrical acupoint stimulation in the elderly patients with general anesthesia for orthopedic surgery and its influence on oxygen metabolism and cognitive state.Method:A total of 80 elderly patients with general anesthesia for orthopedic surgery in Xuzhou Traditional Chinese Medicine Hospital from February 2021 to April 2024 were divided into control group and observation group.The control group(n=40)were treated with routine general anesthesia,the observation group(n=40)were treated with transcutaneous electrical acupoint stimulation before the anesthesia induction on the intervention of control group.The response time,tracheal tube removal time,postanesthesia care unit(PACU)stay time,pain situation(VAS score)and cognitive impairment rates at different time after the operation,hemodynamics state(MAP,HR),oxygen metabolism state[arterio-venous oxygen content difference(Da-jvO2),oxygen extraction ratio(CERO2)]and cognitive state indexes[serum S100 calcium binding protein B(S100B)and nerve growth factor(NGF)]during the perioperative period of two groups were compared.Result:The response time,tracheal tube removal time and PACU stay time of observation group were significantly shorter than those of control group,the VAS scores at 12 and 24 h after the operation were significantly lower than those of control group,the cognitive impairment rates at 1 and 3 d after the operation were significantly lower than those of control group,the differences were statistically significant(P<0.05).The hemodynamics state indexes,oxygen metabolism state and cognitive state indexes of two groups before the treatment were compared,the differences were not statistically significant(P>0.05),the hemodynamics state indexes and oxygen metabolism state indexes of observation group at 30 min during the operation and immediately after the operation were significantly lower than those of control group,the cognitive state indexes at 1 and 3 d after the operation were significantly lower than those of control group,the differences were statistically significant(P<0.05).Conclusion:The application effect of transcutaneous electrical acupoint stimulation in the elderly patients with general anesthesia for orthopedic surgery is better,and it is helpful to promote the postoperative recovery of patients,its influence for oxygen metabolism and cognitive state of patients is more active.
作者
周娜
卢飞飞
冯秀梅
汪丹
ZHOU Na;LU Feifei;FENG Xiumei;WANG Dan(Department of Anesthesiology,Xuzhou Traditional Chinese Medicine Hospital,Xuzhou 221000,China;不详)
出处
《中国医学创新》
2025年第23期27-31,共5页
Medical Innovation of China
基金
徐州市重点研发计划(社会发展)项目(KC22181)。
关键词
经皮穴位电刺激
老年患者
骨科手术
全麻
氧代谢
认知状态
Transcutaneous electrical acupoint stimulation
Elderly patients
Orthopedic surgery
General anesthesia
Oxygen metabolism
Cognitive state
