经皮穴位电刺激在乳腺手术麻醉中的应用  

The Application of Transcutaneous Electrical Acupoint Stimulation in Anesthesia of the Breast Neoplasm Resection

作　　者：司俊丽[1] 张卓文[2] 李国才[1] 肖建斌[1] 

机构地区：[1]广东省中医院,广州510120 [2]浙江中医药大学

出　　处：《浙江中医药大学学报》2016年第3期215-217,共3页Journal of Zhejiang Chinese Medical University

摘　　要：[目的]观察不同穴位组合下经皮穴位电刺激(TEAS)在乳腺肿物切除术静脉麻醉中的临床效果。[方法]将60例择期行单侧乳腺肿物切除术的女性患者,随机分为A、B两组(n=30):A组,静脉全麻+TEAS患侧内关穴、合谷穴;B组,静脉全麻+TEAS患侧内关透外关穴、合谷透劳宫穴、双侧肩井穴。用韩氏穴位电刺激仪进行穴位刺激后行静脉全麻,TEAS持续至术毕,观察并记录TEAS前、TEAS 30 min、麻醉后5 min、麻醉后10 min、手术切皮后5 min、手术结束、苏醒各时间点(分别表示为T1、T2、T3、T4、T5、T6、T7)的脑电双频谱指数(bispectral index,BIS)、心率(heart rate,HR)、平均血压(mean blood pressure,MBP)、Sp O2的变化及切皮时体动反应、苏醒质量,并对有关指标进行统计学分析。[结果](1)TEAS后30 min(T2),B组较A组的BIS值、HR、MBP明显降低,差异有统计学意义(P<0.05);在苏醒时(T7),B组较A组BIS值高,差异有统计学意义(P<0.05)。(2)麻醉全过程丙泊酚及芬太尼的总用量,B组明显低于A组,差异有统计学意义(P<0.05)。[结论]经皮穴位电刺激有强化、协同镇静效应,能显著减少丙泊酚和芬太尼的用量,在全麻乳腺肿物切除术静脉麻醉中有辅助作用。而TEAS患侧内关透外关穴、合谷透劳宫穴及双侧肩井穴的临床效果优于常规穴位刺激,值得临床推广应用。Objective] To observe the clinical effects of transcutaneous electrical acupoint stimulation（TEAS） different acupoints combination in intravenous anesthesia of the breast neoplasm resection. [Methods] 60 selected female patients with unilateral breast neoplasm resection were randomly divided into 2 groups（n=30）, Group A： intravenous anesthesia and TEAS at Hegu ,Neiguan acupoints; Group B： intravenous anesthesia and TEAS at Hegu-Laogong, Neiguan-Waiguan, and bilateral Jianjing acupoints. And then implement the intravenous anesthesia. TEAS continued to the end of the surgery. Observe and record before the TEAS, TEAS 30 min, 5 min, 10 min after anesthesia, after surgery cut skin 5 min; at the end of the surgery, wake up each time point（T1, T2, T3, T4, T5, T6, T7） , the change of BIS, HR, SpO2, MBP and body move when cut the skin reaction, quality of awakening. [Results] TEAS thirty minutes（T2）,BIS,MBP and HR of the group B was obviously lower than that of group A, with a difference between the two groups（ P〈0.05）; T7,group B was higher than group A（P〈0.05）. The total dose of propofol and fentanyl in group B was lower than that group A（P〈0.05）. [Conclusion] The clinical effect of TEAS at Hegu-Laogong, Neiguan-Waiguan, and bilateral Jianjing acupointsis is superior to the conventional acupuncture point stimulation in anesthesia of the breast neoplasm resection.

关 键 词：经皮穴位电刺激 乳腺手术 静脉麻醉 穴位组合 

分 类 号：R245.9[医药卫生—针灸推拿学]