经皮穴位电刺激对颅脑围手术期脑氧及糖代谢的影响  

Effect of Transcutaneous Acupoint Electrical Stimulation on Brain Oxygen and Glucose Metabolism in the Perioperative Period of the Craniocerebral Operation

作　　者：王均炉[1] 任秋生[2] 裴圣林[1] 郑瑞献[1] 杨涛[1] 虞慧畅[1] 谢文霞[1] 

机构地区：[1]温州医学院附属第一医院,浙江325000 [2]浙江省宁波市鄞州人民医院麻醉科

出　　处：《中国中西医结合杂志》2008年第3期201-205,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家重点基础研究发展计划(973计划，No．2007CB512506);浙江省中医药科技计划重点研发项目(No．2006Z018)

摘　　要：目的观察经皮穴位电刺激(TAES)在颅脑手术围术期对脑组织氧及糖代谢的影响。方法将神经外科择期手术患者50例随机分为治疗组和对照组(各25例),两组均麻醉诱导后持续吸入七氟醚和间断静脉注射舒芬太尼、维库溴铵维持麻醉,治疗组加用TAES干预,分别在麻醉诱导前(T_0)、切皮前(T_1)、术毕(T_2)、拔管后10 min(T_3)取颈内静脉球部血及桡动脉血进行血气分析,测定和计算各时相脑动静脉血氧含量差(Da-jvO_2)、脑动静脉血糖含量差(Da-jvGlu)及脑动静脉乳酸含量差(Da-jvLac)。结果两组患者Da-jvO_2在T_1、T_2、T_3均低于T_0(P<0.05,P<0.01),其中治疗组在T_2、T_3与对照组同期比较差异有统计学意义(P<0.05,P<0.0I)。Da-jvGlu治疗组在T_2、T_3明显低于T_0(P<0.05),而对照组在麻醉前后保持相对稳定,组间比较治疗组在T_2、T_3时小于对照组(P<0.05或P<0.01)。Da-jvLac治疗组在T_1、T_2和T_3均低于同期对照组(P<0.01)。结论TAES在颅脑手术围术期应用有可能降低脑组织的氧、糖代谢。Objective To observe the effect of transcutaneous acupoint electrical stimulation （TAES） on brain tissue oxygen and glucose metabolism of the brain tissue in peri-operative period of the craniocerebral operation. Methods Fifty patients scheduled for neuro-surgery were randomly assigned to the treatment group and the control group equally. Anesthesia applied after induction on all patients was continuous sevoflurane inhalation and intermittent intravenous injection of sulfenany and vecurnium bromide, but to the treatment group TASE was applied additionally from 30 min before anesthesia to the end of operation. Blood samples were taken from artery and jugular venous bulb at different time points, i.e. before induction （ T0 ）, before skin incision （ T1 ）, at the end of operation （T2） , and 10 min after extubation （T3 ）, for blood-gas analysis. The difference of oxygen, glucose and lactate contents between blood samples of arterial and jugular bulb （ Da-jvO2, Da-jvGlu and Da-jvLac） at respective time point were determined and calculated. Results Da-jvO2 decreased in both group at T1 , T2 and T3, and all lower than that at T0（P 〈0. 05 or P 〈0. 01 ） , but significant difference was shown in comparison of the index at T2 and T3 with the same time points in the control group in the treatment group （P 〈0. 05 or P 〈0. 01 ）, and that between groups at T2 and T3 （P 〈0. 01 ）. Da-jvGlu in the treatment group decreased at T2 and T3 （P 〈 0. 05 ）, but keep unchanged relatively in the control group before and after anesthesia, inter-group comparison showed it was lower at T2 and T3 in the treatment group than that in the control group respectively （P 〈 0.05 ）. Da-jvGlu in the treatment group at TI, T2, and T3 were all lower than that at the same time points （ P 〈 0. 01 ）. Conclusion TAES can significantly decrease the oxygen and glucose metabolism of the brain tissue in the perioperative period of the craniocerebral operation.

关 键 词：经皮穴位电刺激 颅脑手术 脑 氧 糖 代谢 

分 类 号：R246[医药卫生—针灸推拿学]