电针治疗对老年人腹腔镜肠道手术快速康复的影响  

Effects of electric acupuncture treatment on intestinal laparoscopy in elderly with enhanced recovery after surgery

作　　者：孙怡[1] 张登文[1] 李海风[1] SUN Yi;ZHANG Dengwen;LI Haifeng(Department of Anesthesiology,Guangdong Provincial People′sHospital,Guangdong Academy of Medical Science,Guangzhou 510080,China)

机构地区：[1]广东省人民医院麻醉科广东省医学科学院

出　　处：《实用医学杂志》2019年第11期1837-1840,共4页The Journal of Practical Medicine

基　　金：广东省自然科学资金资助项目(编号:2018A0303130297);广东省医学科学技术研究基金立项资助项目(编号:A2017381)

摘　　要：目的探讨电针治疗对老年人腹腔镜肠道手术后快速康复(ERAS)进程的影响。方法全麻下行腹腔镜肠道手术老年患者随机分为针疗组(P组)和对照组(C组),P组患者在入室后给予电针治疗至手术结束。所有患者术后使用芬太尼静脉输注自控镇痛泵。比较两组术中切皮前后血流动力学改变、术中麻醉药物用量、拔管时间、下床活动时间、术后3、6、12、24、30和48 h芬太尼用量、视觉模拟(VAS)评分及切皮时和术后3 h血浆β-内啡肽浓度。结果切皮后C组患者血流动力学指标较之前增高;切皮时与术后3 h,P组的β-内啡肽浓度高于C组;手术用药比较,P组的麻醉和镇痛药用量显著少于C组;P组患者的拔管、下床时间短于C组;术后3、6 h,P组的芬太尼用量少于C组;术后3、6 h时,P组的安静和咳嗽时VAS评分低于C组,以上差异均有统计学意义(P <0.05)。结论电针促进老年患者术后康复,可作为ERAS的推荐内容。Objective To discuss the effects of electric acupuncture treatment on intestinal laparoscopy in elderly with enhanced recovery after surgery. Methods 72 old patients undergoing intestinal laparoscopy under general anesthesia were allocated randomly to receive electric acupuncture treatment during the operation(group P)or sham therapy(group C). Hemodynamic parameters during skin incision,peri-operative analgesic requirements,the amount of postoperative fentanyl,the time of extubation and ambulation and the concentration of β-endorphin(EP)during skin incision and 3 h after operation in both groups were recorded. Pain was evaluated postoperatively while coughing and at rest by visual analogue scale at 3,6,12,24,30,48 h after operation. Results Hemodynamic parameters in group C were increased more significantly during skin incision than before(P < 0.05). The concentrations of β-EP in group P were higher than those in group C during skin incision and 3 h after operation(P < 0.05). The time of extubation and ambulation were faster in group P than in group C(P < 0.01 and P < 0.05).The usage of remifentanyl and propofol in group P were fewer than those in groupC(P < 0.01). Fentanyl requirement and pain scores were lower in group P than in group C at 3,6 h postoperation(P < 0.05). Conclusion Our results suggest that electric acupuncture treatment can be recommended to be involved into the program of enhanced recovery after surgery for effectively promoting recovery.

关 键 词：电针 快速康复 腹腔镜 内啡肽 肠道手术 老年人 

分 类 号：R246.2[医药卫生—针灸推拿学]