应用针刺复合安氟醚全麻食管癌根治术的临床研究  

Clinical Study on the Effect of Acupuncture Combined with Enflurane General Anesthesia for Esophagectomy

作　　者：唐育民[1] 秦必光[2] 胡北喜[2] 魏湘华[1] 尹志礼[1] 

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

出　　处：《针刺研究》2001年第2期138-142,共5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术的临床应用效果。方法 :采用随机单盲法观察 ,70名食管癌患者随机分为A、B、C三组 ,A组 (n =2 4)即针刺复合安氟醚麻醉组 ,B组 (n =2 3)即电极板穴位刺激复合安氟醚麻醉组 ,C组 (n =2 3)即单纯安氟醚复合麻醉组 (对照组 )。三组静脉诱导和气管插管方法相同 ,麻醉维持静注芬太尼和维库溴铵用量相同 ,对安氟醚吸入浓度则根据病人血压、心率调节 ,术中A、B两组同时开放电刺激仪。结果 :A、B两组麻醉效果优于C组 ,A、B两组麻醉Ⅰ级率分别为 6 2 5 0 %和 6 5 2 2 % ,C组仅为 43 48% ,显著低于A、B两组。麻醉全程安氟醚用量A、B两组分别比C组平均少用 2 9 73%和 37 84%。上述结果具有统计学差异 ,P <0 0 1 ,显示针刺与全麻两者有协同作用。结论 :针麻复合安氟醚全身麻醉下施行食管癌手术 ,麻醉效果肯定 ,方法安全、新颖 ,并能减少安氟醚用量 ,降低麻醉费用 ,由于针麻可调节机体功能 ,能使并发症减少 。Objective: To observe the therapeutic effect of acupuncture combined with enflurane general anesthesia (ACEGA) for esophagectomy. Methods: 70 esophageal carcinoma patients were randomly divided into ACEGA group (n=24), electrical stimulation + enflurane general anesthesia (ES+EGA) group (n=23) and EGA control group (n=23). Xiayifeng Point and Sanyangluo (TE 8) to Ximen (PC 4) were punctured and stimulated with HANS (Apparatus) in patients of ACEGA group and only stimulated with electrical pulses in patients of ES+EGA group. Before enflurane anesthesia, all the patients accepted intramuscular injection of valium (0.1 g/50 kg) and atropine (0.5 mg/50 kg); after anesthesia, they accepted intravenous injection of fentany (2 μg/kg/hr) and vecuronium (0.03 mg/kg/0.5 hr). Results: In ACEGA, ES+EGA and EGA groups, the excellent rates of anesthesia accounted for 62.5% (15 cases), 65.22% (15 cases) and 43.48% (10 cases) respectively; the good rates were 20.83% (6 cases), 26.09% (6 cases) and 52.17% (12 cases) separately; and the poor rates were 16.67% (4 cases), 8.69% (2 cases) and 4.35% (1 case) separately. The dosages of the inhaled enflurane of ACEGA and ES+EGA were 29.73% and 37.84% lower than EGA group separately (P<0.05,P<0.01). There were significant differences between ACEGA and EGA and between ES+EGA and EGA groups in the anesthetic effect (P<0.01), showing a synergistic action between acupuncture/acupoint electrical stimulation and enflurane. Conclusion: Acupuncture combined with unflurane general anesthesia for esophagectomy has a good effect in regulating organic functional activities and reducing complications.

关 键 词：针刺麻醉 安氟醚吸入麻醉 食管癌 外科手术 

分 类 号：R246.2[医药卫生—针灸推拿学] R734.105[医药卫生—中医临床基础]