针药复合麻醉对宫腔镜手术影响的临床研究  

Effect of Application of Acupuncture-Anesthetic Composite Anesthesia on Hysteroscopic Surgery:a Clinical Study

作　　者：杨红[1] 殷岫绮[1] 李国安[2] 袁岚[3] 周华[1] 

机构地区：[1]上海中医药大学附属曙光医院妇科,上海201203 [2]上海中医药大学附属曙光医院针灸科,上海201203 [3]上海中医药大学附属曙光医院麻醉科,上海201203

出　　处：《中国中西医结合杂志》2014年第7期804-807,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：上海市中医药事业发展三年行动计划(重大研究)资助项目(No.ZYSNXD-CC-ZDYJ014);上海市青年医师培养计划项目

摘　　要：目的观察针药复合麻醉对宫腔镜术影响及其安全性。方法以93例行宫腔镜手术的患者为研究对象,随机分为静脉麻醉(A组)、针药复合麻醉(B组)和针刺联合静脉麻醉组(C组),A组采用舒芬太尼联合丙泊酚麻醉,B组采用舒芬太尼联合针刺麻醉,C组采用舒芬太尼、丙泊酚联合针刺麻醉。B、C组选取阴廉穴、曲泉穴。观察患者术中平均动脉压(MAP)、心率(HR)及氧饱和度(SpO2)、手术时间、术毕苏醒时间、舒芬太尼及丙泊酚用量及麻醉不良反应等,同时测量其OAA/S评分、Ramsay镇静评分及视觉模拟评分(visual analogue score,VAS)。结果与A、C组比较,B组患者处于清醒状态,OAA/S评分明显升高(P<0.01);Ramsay镇静评分显著降低(P<0.01);MAP及HR升高(P<0.05);术中SpO2<85%患者例数减少(P<0.05),术后头晕的发生率降低(P<0.05)。与A组比较,C组丙泊酚用量减少(P<0.05)。3组患者手术时间、舒芬太尼用量、VAS评分、术后恶心呕吐的发生率比较,差异无统计学意义(P>0.05)。结论针药复合麻醉患者处于清醒状态,术中镇静程度优于静脉麻醉,镇痛作用与静脉麻醉相当。Objective To observe the analgesic effect and safety of acupuncture-anesthetic composite anesthesia （AACA） in hysteroscopic surgery. Methods Totally 93 patients undergoing hysteroscopic surgery were randomly assigned to the intravenous anesthesia group （A group, 30 cases）, the AACA group （B group, 32 cases）, and the acupuncture combined with intravenous anesthesia group （C group, 31 cases）. Patients in Group A were anesthetized by sufentanil combined propofol. Those in Group B were anesthetized by sufentanil combined acupuncture. Those in Group C were anesthetized by sufentanil, propofol combined acupuncture. Yinlian and Ququan （LR8） were needled for patients in Group B and C. The peri-operative mean arterial pressure （MAP）, heart rate （HR）, and oxygen saturation （SpO2）, the surgical time, the recovery time, the sufentanil and propofol dosages, adverse anesthesia reactions were observed. Meanwhile, the OAA/S score, Ramsay sedation score, and Visual Analogue Score （VAS） were also measured. Results Compared with Group A and C, patients in Group B were a- wake, with obvious increased OAA/S score （P 〈0.01 ）. Ramsay sedation score was significantly lower （P 〈0.01 ）. The MAP and HR were elevated （P 〈0.05）. The patient case of SpO2 less than 85% during the operation decreased （P 〈0.05）. The incidence of postoperative dizziness was reduced （P 〈0.05）. Compared with Group A, the propofol consumption decreased in Group C （P 〈0.05）. There was no statistical difference in the operation time, the sufentanil dosage, VAS score, the incidence of postoperative nausea and vomiting among the three groups （P 〉0.05）. Conclusions The patients were awake in AACA. The intraoperative sedation was better than that obtained by intravenous anesthesia. But the analgesic effect was similar to that obtained by intravenous anesthesia.

关 键 词：针药复合麻醉 宫腔镜手术 镇静评分 OAA S评分 

分 类 号：R614[医药卫生—麻醉学]