针刺复合小剂量硬膜外麻醉胆囊切除术的体会  

Experience of Acupuncture Combined Small Dose Extradural Anesthesia during Cholecystectomy

作　　者：秦必光[1] 刘颖涛[2] 李长根 任业川[4] 张兰英[1] 艾中立[2] 彭晓云 白占勇 

机构地区：[1]成都中医药大学附属医院,成都610072 [2]湖北医科大学附属第二医院,武汉430071 [3]重庆市第四人民医院,630000 [4]四川江油市人民医院,621700

出　　处：《针刺研究》2000年第2期130-136,共7页Acupuncture Research

摘　　要：本研究共观察行胆囊切除术患者 75例 ,分为A组针刺复合小剂量硬膜外麻醉、B组穴位电极刺激复合小剂量硬膜外麻醉、C组单纯小剂量硬膜外麻醉 (对照组 )三组。研究结果 :硬膜外麻醉首次用药量 (1 .5 %利多卡因 )A、B两组比C组分别减少 3 8.1 7%和 2 9.2 7% ,麻醉效果A、B两组Ⅰ级分别为 68.0 0 %和 5 6.0 0 % ,C组Ⅰ级 1 2 .0 0 % ,A、B两组麻醉效果优于C组 ,P <0 .0 0 5。说明 ,针刺 (包括穴位电极刺激 )复合硬膜外麻醉可减少硬膜外麻醉用药量 ,提高麻醉效果 ,满足了腹部手术对麻醉的基本要求 ,弥补了单纯针麻效果的不足 ,术中镇痛完全 ,肌肉松弛 ,牵拉反应轻 ,保留了针麻对生理功能扰乱小的优点 ,使针刺复合硬膜外麻醉可作为胆囊切除术麻醉方法之一。监测提示术前、麻醉后、术中及术毕呼吸、循环功能变化不大 ,但静注唛啶应对RR、SPO2 和胆囊手术中HR、BP的变化密切观察 ,以便早期发现问题 ,及时处理 ,顺利完成手术。cases of cholecystectomy were divided into A group (acupuncture combined small dose extradural anesthesia), B group (stimulating acupoints with electrodes combined small dose extradural anesthesia) and C group (simple small dose extradural anesthesia, control group). The results showed that in A and B groups, the amounts of the first usage of 1.5% lidocaine for extradural anesthesia were reduced 38.17% and 29.27% respectively compared with that of C group. The anesthetic effect up to I grade in A, B, C groups occupied 68.00%, 56.00% and 12.00% separately. The effects of A, B groups were better than that of C group, P<0.005; This indicated that acupuncture (including the acupoints stimulation with electrodes) combined extradural anesthesia may decrease the amounts of extradural use of anesthetics , improve the anesthetic effects and meet the elementary demands for abdominal operations. The anesthesia was complete with little interference on the body's physiological function and made it one choice in clinic. It should be noticed to the influence of respiratory rates, SPO 2, HR and BP after the intravenous injection of meperidine to keep the operation smooth.

关 键 词：针刺麻醉 硬膜外复合麻醉 胆囊切除术 

分 类 号：R657.4[医药卫生—外科学] R246.2[医药卫生—临床医学]