经皮穴位电刺激复合全身麻醉对开颅血肿清除术老年患者围术期血流动力学及机体免疫功能的影响
DOI:
作者:
作者单位:

作者简介:

通讯作者:

中图分类号:

R782.05+3

基金项目:


EffectofTranscutaneousAcupointElectricStimulationCombinedwithGeneral Anesthesia on Perioperative Hemodynamics and Immune Function of the Senile Patients with Craniotomy Evacuation of Hematoma
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的:观察经皮穴位电刺激复合全身麻醉对开颅血肿清除术老年患者围术期血流动力学及机体免疫功能的影响。方法:将纳入研究的60例患者随机分为2组各30例;2组均静注等剂量长托宁、咪达唑仑、丙泊酚、芬太尼、顺-阿曲库铵行麻醉诱导,维持术中脑电双频指数(BIS)40~60。观察组于麻醉前选择双侧足三里、梁丘穴先行经皮穴位电刺激。比较2组诱导前、诱导5 min、切皮时、切皮1 h、手术结束即刻、手术结束30 min平均动脉压(MAP)、心率(HR)水平;并于围术期不同时刻抽取静脉血测定自然杀伤(NK)细胞、CD4+、CD8+及CD4+/CD8+水平进行统计学分析。结果:与同组诱导前比较,观察组切皮时HR升高,对照组诱导5 min、切皮时MAP、HR均升高,差异均有统计学意义(P<0.05)。与对照组比较,观察组诱导5 min、切皮时MAP、HR均降低,差异均有统计学意义(P<0.05)。与同组诱导前比较,2组切皮1 h、手术结束30 min时NK、CD4+、CD4+/CD8+水平降低,CD8+降低,差异均有统计学意义(P<0.05);与对照组比较,观察组切皮1 h、手术结束30 min时NK、CD4+、CD4+/CD8+水平升高,CD8+降低,差异均有统计学意义(P<0.05)。2组不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:经皮穴位电刺激复合全身麻醉行开颅血肿清除术老年患者围术期的血流动力学稳定,且有助于增强机体免疫功能,临床应用安全。

    Abstract:

    Objective: To observe the effect of transcutaneous acupoint electric stimulation combined with generalanesthesia on perioperative hemodynamics and immune function of the senile patients with craniotomy evacuation of hematoma.Methods:Divided 60 study objects into two groups randomly,30 cases in each group.Both groups receivedthe equivalent intravenous injection of penehyclidine hydrochoride,midazolam,propofol,fentanyl and cisatracurium besilate to conduct anaesthesia and maintain bispectral index(BIS)in 40~60 during operation.The observation group received the transcutaneous acupoint electric stimulation at bilateral Zusanli(ST 36)and Liangqiu(ST 34)before anesthesia.Compared mean arterial pressure(MAP)and the levels of heart rate(HR)of the two groups before anaesthesia induction,5 min after anaesthesia induction,during skin incision,1h after skin incision,immediately after operation and 30 min after operation;collected venous blood samples at various time points of preoperation so as to detect levels of natural killer(NK)cells,CD4+,CD8+and CD4+/CD8+and make analysis statistically.Results:In intragroup comparation,HR of the observation group was increased during skin incision,MAP and HR of the control group were both increased 5 min after anaesthesia induction and during skin incision when compared with those before anaesthesia induction.Comparing with the control group,MAP and HR of the observation group were both increased 5 min after anaesthesia induction and during skin incision,differences being significant(P<0.05).In intragroup comparation,the levels of NK,CD4+,CD8+and CD4+/CD8+in both groups were decreased 1 h after skin incision and 30 min after operation when compared with those before anaesthesia induction,differences being significant(P<0.05);comparing with the control group,the levels of NK,CD4+and CD4+/CD8+in the observation group were decreased while the level of CD8+was increased 1 h after skin incision and 30 min after operation,differences being significant(P<0.05).The adverse reaction rate in both group was compared,there being no significance in the difference(P >0.05).Conclusion:The perioperative hemodynamics of transcutaneous acupoint electric stimulation combined with general anesthesia in the treatment of the senile patients with craniotomy evacuation of hematoma is stable and safe,which helps enhance immune function.

    参考文献
    相似文献
    引证文献
引用本文

雷好连,马玉清.经皮穴位电刺激复合全身麻醉对开颅血肿清除术老年患者围术期血流动力学及机体免疫功能的影响[J].新中医,2018,50(1):111-114

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2018-01-05
  • 出版日期: