电针预处理对结直肠癌手术患者肠功能的影响  

Influence of electroacupuncture pretreatment on intestinal function in the patients of colorectal cancer surgery

作　　者：麦思聪 孟尽海[2] 王文娟[2] 郎淑慧[2] MAI Sicong MENG Jinhai WANG Wenjuan LANG Shuhui(Ningxia Medical University, Yinchuan 750004, China Department of Anesthesia, General Hospital of Ningxia MedicaL University. Yinchuan 750004)

机构地区：[1]宁夏医科大学,银川750004 [2]宁夏医科大学总医院麻醉科,银川750004

出　　处：《中国针灸》2017年第5期483-487,共5页Chinese Acupuncture & Moxibustion

摘　　要：目的:观察电针预处理对结直肠癌手术患者肠功能及炎性反应、血乳酸的影响。方法:选择择期行开腹结直肠癌手术的患者60例,年龄18~59岁,美国麻醉医师协会(ASA)分级Ⅰ~Ⅲ级,随机分为A组(全凭静脉给药麻醉组)、B组(全凭静脉给药麻醉复合右侧足三里、上巨虚、下巨虚穴位电针预处理组)、C组(全凭静脉给药麻醉复合中脘、右侧天枢及足三里、上巨虚、下巨虚穴位电针预处理组),每组20例。3组均行全凭静脉给药麻醉,B组、C组于术前一天、术前30min给予相应穴位电针预处理,每次30min。术后观察记录患者肠鸣音恢复时间、通气恢复时间、通便恢复时间、禁饮食时间、腹腔引流管拔除时间及腹腔引流液总量;分别于手术前(T0)、手术结束后24h(T1)及手术结束后第5d(T2)3个时间点采静脉血检测白细胞计数和中性粒细胞计数;于手术前(TⅠ)、肿瘤切除腹腔冲洗后(TⅡ)及手术结束后24h(TⅢ)3个时间点采动脉血测定乳酸值。结果:C组肠鸣音恢复时间、通气恢复时间、禁饮食时间、腹腔引流管拔除时间明显早于A组(均P<0.05)。C组白细胞计数及中性粒细胞计数在T1时点明显少于A组(均P<0.05);与T0时点比较3组在T1、T2时点白细胞计数及中性粒细胞计数明显增多(P<0.05,P<0.01);与T1时点比较3组在T2时点白细胞计数及中性粒细胞计数明显减少(均P<0.01)。TⅠ、TⅡ、TⅢ时点3组间乳酸值比较差异无统计学意义(均P>0.05)。结论:全凭静脉麻醉复合足三里、上巨虚、下巨虚、天枢、中脘穴位电针预处理可以缩短结直肠癌手术患者肠鸣音恢复时间、通气恢复时间、禁饮食时间以及腹腔引流管拔除时间,从而促进肠功能恢复,降低术后24h白细胞计数,以减轻炎性反应,对血乳酸无影响。Objective To observe the effects of electroacupuncture （EA） pretreatment on the intestinal function, inflammatory reaction and blood lactic acid in the patients of colorectal cancer surgery.Methods Sixty patients of colorectal cancer laparotomy at selective period, aged from 18 to 59 years old were selected.According toⅠ-Ⅲ grade of American Society of Anesthesiologists （ASA）, the patients were randomized into group A （total intravenous anesthesia）, group B [total intravenous anesthesia combined with EA pretreatment at Zusanli （ST 36）, Shangjuxu （ST 37） and Xiajuxu （ST 39） on the right side] and group C [total intravenous anesthesia combined with EA pretreatment at Zhongwan （CV 12）, Tianshu （ST 25）, Zusanli （ST 36）, Shangjuxu （ST 37） and Xiajuxu （ST 39） on the right side], 20 cases in each one.The total intravenous anesthesia was applied to all of the three groups.EA pretreatment was used one day before surgery and 30 min before surgery at corresponding acupoints in the group B and group C separately, 30 min each time.After surgery, the recovery time of bowel sound, the recovery time of flatus, the recovery time of defecation, the duration of diet fasting, the time of peritoneal drainage tube withdrawal and the total peritoneal drainage volume were observed in the three groups.The venous blood was collected to determine white blood cell count （WBC） and neutrophil count （NEUT） before surgery （T0）, 24 h after surgery （T1） and on the 5th day after surgery （T2） separately.The arterial blood was collected to determine the level of lactic acid before surgery （TⅠ）, after peritoneal douching （TⅡ） and 24 h after surgery （TⅢ） separately.Results The recovery time of bowel sound, the recovery time of flatus, the duration of diet fasting and the time of peritoneal drainage tube withdrawal in the group C were apparently earlier than those in the group A （all P〈0.05）.WBC and NEUT at T1 in the group C were apparently less than those in the

关 键 词：结直肠癌手术 电针 预处理 肠功能 炎性反应 

分 类 号：R246.2[医药卫生—针灸推拿学]