经皮穴位电刺激对单肺通气期间氧合和肺内分流的影响  

Effect of Trancutaneous Electrical Acupoint Stimulation of "Kong Zui"(孔最) and "Fei Yu"(肺俞) Acupoints on Oxygenation and Pulmonary Shunt during One Lung Ventilation

作　　者：任秋生 王均炉[2] 包峰峰 耿武军[2] 

机构地区：[1]浙江省宁波市鄞州人民医院麻醉科,宁波315040 [2]浙江省温州医学院第一附属医院麻醉科 [3]浙江省宁波市鄞州人民医院针灸科

出　　处：《中国中西医结合外科杂志》2011年第3期250-254,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：浙江省宁波市医学科技计划项目(2008029)

摘　　要：目的:观察开胸手术中经皮电刺激穴位对单肺通气期间肺氧合及肺内分流的影响。方法:将择期开胸手术患者46例随机分为经皮穴位电刺激组(E组)和对照组(C组)。E组在麻醉诱导前30min开始经皮电刺激两侧孔最、肺俞穴。分别于平卧双肺通气30min(T1)、侧卧双肺通气30min(T2)、单肺通气15min(T3)、30min(T4)、60min(T5)各时点抽取桡动脉血及中心静脉导管血2mL,检测和计算pH、PaCO2、PaO2、SaO2、PvO2、SvO2、Hb、Qs/Qt。结果:两组患者PaO2、SaO2在单肺通气(T3、T4、T5)后开始下降(P<0.05),E组在T3、T4、T5时点明显高于C组(P<0.05)。两组患者Qs/Qt在单肺通气(T3、T4、T5)后开始升高,E组在T3、T4、T5时点明显低于C组(P<0.05)。结论:经皮电刺激孔最、肺俞穴位可以降低单肺通气时的肺内分流率,改善肺的氧合作用。Objective To observe the effect of transcutaneous electrical acupoint stimulation （TEAS） of Kongzui （LV6） and Feiyu （BL13） acupoints on oxygenation and pulmonary shunt during one lung ventilation.Methods A total of 46 patients scheduled for thoracotomy were randomized into TEAS （E group） and control group （C group）,with 23 cases in each.Patients in E group were administered with TEAS of Kongzui and Feiyu points 30 min before anesthesia induction,till operation completion.Anesthesia of the patients were maintained with isoflurane inhalation and intermittent i.v.boluses of fentanyl and vecuronium bromide.Blood samples 2 mL were respectively taken from radial artery and central venous catheter simultaneously at 30 min after two lung ventilation （TLV） in the supine position （T1）,30 min after TLV in the lateral position （T2）,15 min,30 min,60 min after one lung ventilation （OLV） for blood gas analysis.pH,PaCO2,PaO2,SaO2,PvO2,SvO2,Hb and Qs/Qt of the sample were determined and calculated.Results PaO2,SaO2,of patients in two groups declined at T3,T4,T5 after OLV （P 0.05）,PaO2.SaO2 in E group were superior significantly to C group at T3,T4,T5 （P 0.05）.Qs/Qt of patients in two groups increased significantly at T3,T4,T5 after OLV （P 0.05）.Qs/Qt of E group wee lower significantly than C group at T3,T4,T5 （P 0.05）.Conclusion TEAS of ＂kong zui＂ and ＂Fei yu＂ acupoints may reduce pulmonary shunt,improve lung oxygenation during one lung ventilation,the mechanism may be that TEAS facilitates and regulates hypoxic pulmonary vasoconstriction.

关 键 词：单肺通气 肺内分流 氧合作用 经皮穴位电刺激 孔最 肺俞 

分 类 号：R246[医药卫生—针灸推拿学]