电针预处理对于老年关节置换术后认知功能障碍的影响  

Effects of electroacupuncture preconditioning on postoperative cognitive dysfunction in elderly patients undergoing joint replacement

作　　者：姜慧丽[1] 陈利海[2] 王丹丹[1] 郑曼[1] 崔苏扬[1] 

机构地区：[1]南京中医药大学附属医院,江苏省中医院麻醉科,江苏南京210000 [2]南京市第一医院麻醉科

出　　处：《上海医学》2014年第12期1017-1019,共3页Shanghai Medical Journal

摘　　要：目的探讨电针预处理对老年患者关节置换手术术后认知功能障碍(POCD)的影响。方法选取2012—2013年在江苏省中医院择期行髋关节或膝关节置换手术的老年患者90例,随机分入对照组和电针组,每组45例。电针组患者于术前5d开始,每天选取患者的百会、大椎二穴给予电针预处理;对照组患者不给予。在术前1d和术后1、7d,应用简易精神状态量表(MMSE)评估患者的认知功能,术后MMSE评分较术前基础值减值≥2分者诊断为POCD。结果共88例患者完成本研究,电针组43例,对照组45例。术后1d,电针组的POCD发生率为20.9%(9/43),显著低于对照组的35.6%(16/45,P<0.05)。术后7d,电针组的POCD发生率为9.3%(4/43),有低于对照组15.6%(7/45)的趋势,但差异无统计学意义(P=0.375)。结论电针预处理百会、大椎二穴可以降低老年患者关节置换手术后1d的POCD发生率,但对术后7d的POCD发生率并无影响。Objective To investigate the effects of electroacupuncture preconditioning on postoperative cognitive dysfunction （POCD） in elderly patients undergoing joint replacement. Methods Ninety patients scheduled for hip or knee joint replacements in Jiangsu Hospital of Traditional Chinese Medicine from 2012 to 2013 were randomly divided into two groups （n = 45） . electroacupuncture group and control group： Electric acupuncture （both Baihui and Dazhui acupoints） was performed in the electroacupuncture group for 5 consecutive days before surgery. Mini-mental state examination （MMSE） was used to evaluate the cognitive function in all patients on day 1 before surgery and day 1 and 7 after surgery. Those patients whose postoperative MMSE score was two or more than two points less than baseline were diagnosed as POCD. Results Eighty-eight patients completed the tests in the study; 43 in electroacupuncture group and 45 in control group. The incidence of POCD at the 1^st day after surgery in electroacupuncture group （20.93 %, 9/43） was significantly lower than that in control group （35.56%, 16/45, P〈0.05）. The incidence rates of POCD at the 7^th day after surgery were 9.3% （4/43） and 15.6% （7/ 45） in electroacupuncture group and control group, respectively （P = 0. 375）. Conclusion Electroacupuncture preconditioning （Baihui and Dazhui acupoints） can reduce the incidence of POCD on day 1 after surgery in elderly patients undergoing joint replacement, but it has no effect on POCD at the 7^thday after surgery. （Shanghai Med J, 2014, 37： 1017-1019）

关 键 词：电针 百会穴 大椎穴 关节置换手术 术后认知功能障碍 

分 类 号：R614[医药卫生—麻醉学]