针刺辅助全麻在后循环缺血性脑卒中支架置入术中的应用  

Application of Acupuncture as Adjunct to General Anesthesia in Stent Implantation for Posterior Circulation Ischemic Stroke

作　　者：赵春美[1] 谢思宁[1] 张晴[1] 贾春蓉[1] 安立新 ZHAO Chun-mei1, XIE Si-ning1, ZHANG Qing1, JIA Chun-rong1, AN Li-xin2.(1.Beijing Tian Tan Medical University, Beijing 100050, China; 2.Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China)

机构地区：[1]首都医科大学附属北京天坛医院,北京100050 [2]首都医科大学附属北京友谊医院,北京100050

出　　处：《上海针灸杂志》2018年第7期751-757,共7页Shanghai Journal of Acupuncture and Moxibustion

基　　金：北京市中医药发展基金项目(JJ2014-04)

摘　　要：目的观察针刺辅助全身麻醉对后循环缺血性脑卒中患者围术期脑血流及脑神经功能的影响。方法将52例后循环缺血性脑卒中(PCIS)支架置入术患者,根据随机数字表法分为电针组(A组)19例,经皮穴位电刺激组(T组)18例和假电针对照组(C组)15例。A组进行针刺,T组进行经皮穴位电刺激,C组采用假电针。测定所有患者术前、治疗30 min后、术后30 min、术后1天大脑后动脉(Posterior cerebral artery,PCA)的平均脑血流速度(Vm)。记录术后1周、1个月和3个月的NIHSS、mRS评分。结果 3组PCA术前、术后30 min、术后1 d Vm比较差异均无统计学意义(P>0.05)。A组和T组治疗30 min后PCA的Vm较术前升高(P<0.05)。术后1周,A组和T组NIHSS评分均低于C组(P<0.05),A组和T组mRS评分为0级的患者均多于C组(P<0.05)。而3组术后1个月、3个月的神经功能评分比较差异无统计学意义(P>0.05)。结论电针或经皮穴位电刺激复合全身麻醉应用于PCIS患者,刺激30 min可增加PCA脑血流,加速术后早期(1周)的神经功能恢复,而对远期的神经功能预后没有影响,是一种值得应用的麻醉方法。Objective To observe the effect of acupuncture as adjunct to general anesthesia on perioperative cerebral circulation and cranial nerve function in posterior circulation ischemic stroke（PCIS）. Method Fifty-two PCIS patients going to receive stent implantation were randomized by using the random number table into an electroacupuncture group（group A） of 19 cases, a transcutaneous electrical acupoint stimulation group（group T） of 18 cases and a sham electroacupuncture control group（group C） of 15 cases. Group A received acupuncture, group T received transcutaneous electrical acupoint stimulation, and group C received sham electroacupuncture, respectively. The mean cerebral blood flow velocity（Vm） of the posterior cerebral artery（PCA） was detected prior to the operation, after 30-minute treatment, 30 min after the operation, and 1 d after the operation. The National Institute of Health Stroke Scale（NIHSS） and modified Rankin Scale（mRS） scores were recorded 1 week, 1 month and 3 months after the operation. Result The inter-group differences among the three groups in the Vm of PCA were statistically insignificant prior to the operation, 30 min after the operation and 1 d after the operation（P〈0.05）. The Vm of PCA increased significantly in group A and T after 30-minute treatment compared with the value prior to the operation（P〈0.05）. One week after the operation, the NIHSS scores of group A and T were significantly lower than the score of group C（P〈0.05）, and there were more patients estimated level 0 by the mRS in group A and T compared with the number of people in group C（P〈0.05）. One month and 3 months after the operation, there were no significant differences in the nerve function score among the three groups（P〈0.05）. Conclusion Thirty minutes of electroacupuncture or transcutaneous electrical acupoint stimulation as adjunct to general anesthesia can increase the blood flow of PCA, accelerate the recovery of nerve function in the early stage（in one wee

关 键 词：针刺疗法 经皮穴位电刺激 电针 血管假体植入 脑梗死 

分 类 号：R246.2[医药卫生—针灸推拿学]