针刺复合基础麻醉与单纯基础麻醉应用于腹膜透析置管手术麻醉效果的比较  

Comparison of anesthetic effects of acupuncture combined with basic anesthesia and simple basic anesthesia for peritoneal dialysis catheterization

作　　者：杨强[1] 瞿敏[1] 姚忠岩[1] 张秀青 李晨晨 李蕾[2] YANG Qiang;QU Min;YAO Zhong-yan;ZHANG Xiu-qing;LI Chen-chen;LI Lei(Department of Anesthesiology, Cangzhou Central Hospital, Hebei Province, Cangzhou 061000, China;Physical Examination Center, Cangzhou Central Hospital, Hebei Province, Cangzhou 061000, China)

机构地区：[1]河北省沧州市中心医院麻醉科,河北沧州061000 [2]河北省沧州市中心医院体检中心,河北沧州061000

出　　处：《河北医科大学学报》2019年第8期933-936,共4页Journal of Hebei Medical University

摘　　要：目的比较针刺复合基础麻醉与单纯基础麻醉应用于腹膜透析置管手术的有效性及安全性。方法选取首次行腹膜透析置管术的患者69例,采用随机数字表法分为针刺复合基础麻醉组(AA组)和单纯基础麻醉组(BA组)。手术开始前20min,2组均静脉泵注0.3μg/kg右美托咪定镇静,AA组于手术开始前连续电刺激双侧内关穴及三阴交穴至术毕。术中视觉模拟评分法(Visual AnalogueScale,VAS)评分大于5分,可给予静脉注射芬太尼1μg/kg,如芬太尼总量达5μg/kg后VAS评分大于5分者,则改为全身麻醉完成手术。记录2组手术切皮时、牵拉及切开腹膜时、建立皮下隧道时、缝皮时、术后2h、术后12h及术后24h的VAS评分。记录术中镇痛药芬太尼的追加量,手术医生对麻醉效果的满意度,术中转全身麻醉率及麻醉手术相关不良反应。结果2组术中VAS评分在手术切皮开始逐渐增高至缝皮时降低,2组术后VAS评分逐渐降低,2组术中、术后VAS评分在组间、时点间、组间·时点间交互作用差异均有统计学意义(P<0.05),AA组追加镇痛药芬太尼的总剂量明显少于BA组(P<0.05)。与BA组比较,AA组手术医师满意度高,转全身麻醉率较低,差异均有统计学意义(P<0.05)。结论腹膜透析置管手术中采用针刺复合基础麻醉较单纯基础麻醉安全、有效。Objective To compare the efficacy and safety of acupuncture combined with basic anesthesia and simple basic anesthesia in peritoneal dialysis catheterization. Methods Sixty-nine patients with first-time peritoneal dialysis catheterization were selected. By random number table method the patients were divided into acupuncture combined basic anesthesia group(AA group) and simple basic anesthesia group(BA group). Acupuncture at Neiguan and Sanyinjiao points with electrical stimulated at 20 minutes before start of surgery in AA group. The same position paste the electrode connect the point of electrical stimulation instrument in BA group. Both groups of patients were sedated with intravenous injection of 0.3 μg/kg dexmedetomidine 20 minutes before the start of surgery. In AA group, bilateral Neiguan and Sanyinjiao acupoints were stimulated continuously until the end of operation. If intraoperative Visual Analogue Scale(VAS) score was greater than 5 points, intravenous fentanyl 1 μg/kg could be administered. If the VAS score was greater than 5 after total fentanyl 5 μg/kg, general anesthesia was used to complete the operation.The VAS scores of the two groups were recorded during surgical incision, traction and incision of the peritoneum, establishment of subcutaneous tunnel, suture, 2 h after surgery, 12 h after surgery and 24 h after surgery. The additional amount of analgesic fentanyl, the surgeon′s satisfaction with the anesthetic effect, the general anesthesia during surgery, and the adverse reactions associated with anesthesia were recorded. Results The intraoperative VAS score of the two groups decreased gradually from the beginning of surgical incision to the suture, and the postoperative VAS score of the two groups decreased gradually. The interaction differences between the two groups of intraoperative and postoperative VAS score were statistically significant( P < 0.05). The total dose of fentanyl was significantly lower in the AA group than in the BA group( P < 0.05). Compared with the BA group, the sa

关 键 词：腹膜透析 置管术 针刺麻醉 基础麻醉 

分 类 号：R459.5[医药卫生—治疗学]