经皮穴位电刺激对腹腔镜胆囊摘除术全麻复苏期应激反应的影响  

Effect of Transcutaneous Acupoint Electrical Stimulation on Stress Reactions in Laparoscopic Cholecytectomy(LC) under Anesthesia

作　　者：徐韶怡[1] 黄玉霜[1] 陈雄为 杨洁虹 张亮[1] 

机构地区：[1]温州市中医院,浙江温州325000

出　　处：《中华中医药学刊》2016年第5期1209-1211,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：温州市第二期科技计划项目(Y20120267)

摘　　要：目的:探讨经皮穴位电刺激(transcutaneous acupoint electrical stimulation,TSES)对腹腔镜胆囊摘除术(laparoscopic cholecytectomy,LC)全麻复苏期应激反应的影响。方法 60例ASAI^II全麻下实施腹腔镜胆囊摘除术的患者,随机分为实验组和对照组,实验组于全麻诱导前刺激双侧内关、合谷、足三里穴30 min;对照组患者在穴位上贴电极片,不做电刺激。观察记录拔管前5 min(T1)、拔管即刻(T2)、拔管后5 min(T3)、10 min(T4)、15min(T5)的平均动脉压(MAP)、心率(HR),在5个时点采集颈内静脉血6 m L,检测血浆肾上腺素(E)、去甲肾上腺素(NE)和皮质醇(Cor)浓度;观察记录唤醒时间、拔管时间、拔管时呛咳躁动的发生率,及术后24 h内头晕、寒战、恶心呕吐等不良反应的发生情况。结果与拔管前5 min比较,对照组患者MAP、HR及血浆E、NE、TN浓度在T2、T3、T4、T5时点均上升(P<0.05);实验组在上述时间点均上升幅度较小,组间比较差异有统计学意义(P<0.05);唤醒时间、拔管时间、拔管时躁动发生率两组间差异无统计学意义(P>0.05),两组在拔管时呛咳的发生率的差异有统计学意义(P<0.05);术后24 h内头晕、寒战的发生率两组间无统计学意义(P>0.05),术后24 h内恶心呕吐两组间的差异有统计学意义(P<0.05)。结论腹腔镜胆囊摘除术全麻复苏期可出现剧烈的应激反应,经皮穴位电刺激对此反应具有抑制作用,且减少术后24 h内的不良反应。Objective： To observe the effect of transcutaneous acupoint electrical stimulation（ TSES） on stress reactions in laparoscopic cholecytectomy under anesthesia. Methods： A total of 60 patients of ASA- II grade who underwent LC with general anesthesia were randomly divided into TAES group and control group. In TAES group,electrical stimulations of bilateral Neiguan（ PC6）,Hegu（ LI4） and Zusanli（ ST36） were performed for 30 minutes before induction of anesthesia. Patients in control group received electrode plate without electrical stimulation. The mean artery pressure（ MAP）,heart rate（ HR） and the contents of plasma adrenaline（ E）,norepinephrine（ NE） and cortisol were measured at 5 min before extubation（ T1）,at extubation（ T2）,5 min（ T3）,10 min（ T4） and 15 min（ T5） after the extubation. Patients＇ waking up time,time for extubation and the incidence of cough and restlessness were recorded. Besides,the incidence of adverse reactions in 24 hours after the surgery,such as dizzy,nausea and vomiting,was also recorded. Results： Compared with contents of MAP,HR,BIS score at T1 and the contents of E and NE at T2,T3 and T4 in control group were significantly increased（ P〈0. 05）. Those records in group TAES were just increased a little. There were significant differences between groups（ P〈0. 05）. There was no significant difference on the incidence of adverse reactions in 24 hours after the surgery between two groups（ P〉0. 05）. Conclusion： Laparoscopic cholecytectomy can lead to severe stress reactions and transcutaneous acupoint electrical stimulation has inhibitory effect. And it also can decrease the incidence of adverse reactions in 24 hours after the surgery.

关 键 词：经皮穴位电刺激 腹腔镜胆囊切除术 应激反应 

分 类 号：R246.2[医药卫生—针灸推拿学]