经皮穴位电刺激对腹腔镜手术全麻患者脑保护及应激作用的研究  

Study on brain protection and oxidative stress on general anesthesia patients of laparoscopic surgery by TEAS

作　　者：于波[1] 丁玲玲 陆斌[1] 王麒[1] YU Bo;DING Lingling;LU Bin(Department of Anesthesiology,Beijing Traditional Chinese Medicine Hospital,Capital Medical University,Beijing 100010)

机构地区：[1]首都医科大学附属北京中医医院麻醉科

出　　处：《陕西中医》2020年第2期241-244,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：北京市科技计划课题(Z171100001017061)

摘　　要：目的:探讨经皮穴位电刺激(TEAS)对腹腔镜手术全麻患者脑保护及应激反应的作用。方法:选择96例在我院行腹腔镜手术的患者作为研究对象,依随机的原则分为两组,观察组(48例)在麻醉过程中应用TEAS,对照组(48例)不应用电刺激。两组均应用异丙酚和瑞芬太尼TCI全凭麻醉,观察麻醉药物使用量,术后第1、2、3天时谵妄发生率,术前、术中、术毕及术后第1、2、3天时脑源性神经营养因子(BDNF)、S-100B蛋白(S100B)、神经胶质纤维酸性蛋白(GFAP)、超氧化物歧化酶(SOD)和微小RNA497-5p(miR-497-5p)的表达。结果:观察组的麻醉药物使用量明显低于对照组(P<0.05),观察组术后3d内谵妄发生率明显低于对照组(P<0.05),观察组与对照组在术中、术毕、术后第1、2天时BDNF、S100B、GFAP、SOD和miR-497-5p的表达差别有统计学意义(P<0.05)。结论:腹腔镜手术患者全麻时积极应用TEAS能减少麻醉药物的使用量,降低术后谵妄的发生率,减少脑损伤因子的形成,增加BDNF的分泌,降低机体的氧化应激反应。Objective:To investigate the effect on brain protection and stress response in patients of laparoscopic general anesthesia by TEAS.Methods:96 patients who underwent laparoscopic surgery were selected as the study objects.96 patients were divided into two groups.Both groups were anesthetized with propofol and remifentanil TCI.Observation group(48 cases)added TEAS during anesthesia,and the control group(48 cases)did not use TEAS.The dosage of anesthetics was oberved in two groups.Incidence of delirium was observed on the 1st,2nd and 3rd day after operation.Expressions of BDNF,S-100 B,GFAP,SOD and miR-497-5 p were observed on before operation,during operation,finish operation,1st,2nd and 3rd day after operation.Results:The dosage of anesthetics was significantly lower in the observation group than that in the control group(P<0.05).Incidence of delirium was significantly lower in the observation group than that in the control group within 3 days(P<0.05).Expressions of BDNF,S100B,GFAP,SOD and miR-497-5p were different on during operation,finish operation,the 1st,2nd and 3rd day after operation.Conclusion:TEAS can reduce dosage of anesthetics,reduce the incidence of postoperative delirium,reduce the formation of brain injury factors,increase the secretion of BDNF,reduce oxidative stress response,should be actively used in clinical treatment.

关 键 词：经皮穴位电刺激 腹腔镜 麻醉 脑保护 应激反应 

分 类 号：R614[医药卫生—麻醉学]