针刺复合安氟醚吸入全麻食管癌切除临床研究总结  

Summary of Clinical Research on Acupuncture Anesthesia in Combination with General Anesthesia of Enflurane Inhalation for Resection of Esophageal Carcinoma

作　　者：尹志礼[1] 秦必光[2] 王焱林[3] 胡北喜[2] 唐育民[1] 万德宁[3] 

机构地区：[1]四川省肿瘤医院,成都610041 [2]成都中医药大学附属医院,成都610072 [3]湖北医科大学附属第二医院,武汉430071

出　　处：《针刺研究》2001年第1期38-44,共7页Acupuncture Research

基　　金："九.五"国家攻关课题!(编号 :96 90 6 11 0 1)

摘　　要：目的 :观察针刺复合安氟醚全麻下实施食管癌根治手术的临床应用效果。方法 :采用随机单盲方法将 1 2 0名食管癌患者随机分为A、B、C三组。A组 (n =40 ) :针刺复合安氟醚吸入全麻组 ;B组 (n =41 ) :电极板穴位刺激复合安氟醚吸入全麻组 ;C组 (n =3 9) :单纯安氟醚吸入全麻组(对照组 )。麻醉诱导三组均静注维库溴铵、芬太尼、异丙酚 ,剂量相同。三组术中均静注芬太尼(2 μg·kg- 1 ·hr- 1 )、维库溴铵 (0 .0 3mg·kg- 1 ·0 .5hr- 1 ) ,并根据麻醉需要吸入安氟醚适宜浓度维持麻醉和肌松。A、B两组同时开放电刺激仪。结果 :A、B两组麻醉Ⅰ级率各为 67.5 0 %、68.2 9% ,C组Ⅰ级率仅 2 8.2 1 % ,两者比较P <0 .0 0 1 ;麻醉全过程安氟醚平均浓度 (ETEnf)A、B两组分别为0 .5 5 %、0 .5 0 % ,C组为 0 .83 % ,A、B两组比C组吸入安氟醚浓度分别低 (少 ) 3 3 .73 %、3 9.76% ,P <0 .0 0 5。结论 :针刺复合安氟醚吸入全麻不但增强镇痛效果 ,而且减少安氟醚吸入用量 ,并突出了针麻优越性 ,可供临床选用。Objective: To observe the clinical effect of acupuncture anethesia in combination with general anesthesia of enflurane for radical operation of esophageal carcinoma. Methods:Single blind test has been adopted and 120 cases were divided at random into 3 groups, i.e. A, B, C. Group A (n=40): acupuncture integrated with general anesthesia of enflurane inhalation. Group B (n=41): acupoint stimulation with plate electrode combined with general anesthesia of enflurane inhalation. Group C (n=39): simple inhalation general anesthesia (control group). Acupoints used were Yifeng (TE 17), Sanyangluo (TE 8) to Ximen (PC 4) and Xiayifeng and were stimulated with electric current 2～ 4 mA, frequency 2/15 Hz and intermittent dense sparse waves in Group A. Sanyangluo (TE 8) and Xiayifeng were stimulated with 10～13 mA via skin electrodes. For anesthesia induction all the 3 groups received same dose of intravenous injection of vecuromine, fentanyl and isophorone. During the operation all the groups received intravenous injection of fentany (2 μg·kg -1 ·hr -1 ), and vecuromine (0.03 mg·kg -1 ·0.5 hr -1 ), and inhaled the enflurane of appropriate concentration to maintain anesthesia and muscular relaxation according to the requirements for anesthesia. In group A and Group B the electric stimulation were used at the same time.Results: In Group A and Group B the rate of anesthesia grade I is 67.50% and 68.29% respectively, whereas in group C the rate of Grade I is merely 28.21%,P<0.001; In the whole process of anesthesia the average concentration of enflurane in Group A and Group B was 0.55% and 0.50% respectively, but in Group C it was 0.83%. The inhaled enflurane concentration in Group A and Group B is 33.73% and 39.76% respectively being strikingly lower than that of Group C (P<0.005).Conclusion:Acupuncture combined with general anesthesia of enflurane inhalation can not only enhance the analgesic effect, but also reduce the inhalation dosage of enflurane, it reveals the advantage of acu

关 键 词：针刺麻醉 安氟醚吸入麻醉 食管癌 外科手术 麻醉 全麻 

分 类 号：R735.1[医药卫生—肿瘤] R246.2[医药卫生—临床医学]