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经皮穴位电刺激对腹腔镜胆囊切除术患者术后早期恢复质量的影响 预览

Effect of transcutaneous acupoint electrical stimulation on early recovery quality of patients after laparoscopic cholecystectomy
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摘要 目的探讨经皮穴位电刺激在提高腹腔镜胆囊切除术(LC)患者术后早期恢复质量的临床效果。方法选取2016年1月~2018年10月首都医科大学附属北京中医医院收治的LC患者93例为研究对象,根据随机数字表法分为对照组(46例)和研究组(47例)。对照组行LC术时给予右美托咪定,研究组行LC术时给予经皮穴位电刺激联合右美托咪定,比较两组麻醉前(T1)、插管5 min后(T2)、气腹建立5 min后(T3)、气腹建立15 min后(T4)、术毕(T5)时的心率(HR)、平均动脉压(MAP);比较两组患者T1、T5、术后1 d(T6)的白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、神经元特异性烯醇化酶(NSE)以及超氧化物歧化酶(SOD)水平;比较两组术后谵妄分级量表评分、镇静评分、视觉模拟评分(VAS)以及舒适度评分,记录两组治疗期间不良反应发生情况。结果对照组HR、MAP在T2~T5均高于T1(P<0.05),研究组HR、MAP在T2~T5与T1比较差异无统计学意义(P>0.05),研究组HR、MAP在T2~T5显著低于同期对照组(P<0.05)。两组SOD水平在T5较治疗前降低,但研究组高于对照组(P<0.05),NSE较治疗前升高,但研究组低于对照组(P<0.05)。两组IL-6、TNF-α在T5、T6浓度均较T1升高,但研究组低于对照组(P<0.05)。两组患者术后VAS、舒适度评分比较差异无统计学意义(P>0.05),研究组术后谵妄分级量表评分低于对照组,镇静评分高于对照组(P<0.05)。两组患者不良反应总发生率比较差异无统计学意义(P>0.05)。结论 LC术中应用经皮穴位电刺激,可维持血流动力学稳定,改善血清SOD、NSE、IL-6、TNF-α水平,且不增加不良反应发生率,有效改善患者早期恢复效果。 Objective To explore the clinical application of transcutaneous acupoint electrical stimulation in improving the early recovery quality of patients after laparoscopic cholecystectomy (LC). Methods A total of 93 patients with LC admitted to Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical University from January 2016 to October 2018 were selected as the study objects. They were divided into control group (46 cases) and research group (47 cases) according to random number table method. The control group was given Dexmedetomidine during LC, and the research group received transcutaneous acupoint electrical stimulation combined with Dexmedetomidine during LC. Heart rate (HR) and mean arterial pressure (MAP) were compared at before anesthesia (T1), 5 min after intubation (T2), 5 min after establishment of pneumoperitoneum (T3), 15 min after establishment of pneumoperitoneum (T4), and 5 min after operation (T5). The level of interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), neuron specific enolation (NSE) and superoxide dismutase (SOD) at T1, T5 and postoperative 1 day(T6) were compared between the two groups. The postoperative delirium rating scale score, sedation score, visual analogue score (VAS) and comfort score were compared between the two groups. The occurrence of adverse reactions during treatment was recorded. Results The HR and MAP of control group at T2-T5 time point were higher than those at T1 time point (P<0.05). There was no significant difference in HR and MAP between the time points of T2-T5 and T1 in the research group (P > 0.05). HR and MAP of the research group at T2-T5 time points were significantly lower than those in the control group at the same time point(P<0.05). The SOD of the two groups at T5 time point was lower than that before treatment, but the SOD of the research group was higher than that of the control group;NSE was higher than before treatment, but lower in the research group than in the control group (P<0.05). The levels of IL-6 and TNF-α at T5 and
作者 陆斌 王麒 丁玲玲 LU Bin;WANG Qi;DING Lingling(Department of Anesthesia, Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical University, Beijing 100010, China)
出处 《中国医药导报》 CAS 2019年第13期112-115,119共5页 China Medical Herald
基金 北京市科技计划项目(Z171100001017061)。
关键词 经皮穴位 电刺激 腹腔镜胆囊切除术 术后 早期恢复 临床应用 Transcutaneous acupoints Electrical stimulation Laparoscopic cholecystectomy Postoperative Early recovery quality Clinical application
作者简介 通讯作者:丁玲玲(1971.8-),女,博士,主任医师;研究方向:麻醉。
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