不同电针频率在肺切除术患者针刺麻醉中的应用及对应激反应、免疫功能的影响  

Application of Different Electroacupuncture Frequencies in the Acupuncture Anesthesia of Patients Undergoing Pneumonectomy and its Effects on Stress Response and Immune Function

作　　者：刘智[1] 彭赛 周启 LIU Zhi;PENG Sai;ZHOU Qi(Department of Anesthesiology,The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410007 China)

机构地区：[1]湖南中医药大学第一附属医院麻醉科

出　　处：《湖南中医药大学学报》2020年第2期209-213,共5页Journal of Hunan University of Chinese Medicine

基　　金：湖南省科技厅重点研发项目（2015JC3071）;湖南省卫健委一般项目（B20180623）

摘　　要：目的探讨不同电针频率在肺切除术患者针刺麻醉中的应用效果。方法选取108例行肺切除术患者,随机分为A、B、C、D 4组,各27例。4组患者均行全身麻醉,A组给予假针刺,B、C、D组给予经穴电针刺激,其中B组电针频率2 Hz、C组电针频率100 Hz、D组电针频率2 Hz/100 Hz。记录患者术中的麻醉药物追加量、生命体征、肾上腺素和皮质醇水平、T淋巴细胞亚群CD4+/CD8+比值。结果(1)与A组比较,B、C、D组芬太尼追加量较低(P<0.05);与B、C组比较,D组芬太尼追加量较低(P<0.05)。(2)4组患者丙泊酚追加量比较,差异无统计学意义(P>0.05)。(3)麻醉诱导期,B、C、D组的平均动脉压、呼吸频率均小于A组(P<0.05)。(4)与A组比较,B、C、D组术中肾上腺素水平较低(P<0.05);与C、D组比较,B组术中肾上腺素水平较低(P<0.05)。(5)与A组比较,B、C、D组术中皮质醇水平较低(P<0.05);与C组比较,B、D组术中皮质醇水平较低(P<0.05)。(6)手术期间,B、C、D组的CD4+/CD8+均高于A组(P<0.05)。(7)4组患者全麻相关并发症比较,差异无统计学意义(P>0.05),无针刺不良反应发生。结论患者行全麻时联合针刺麻醉,可以减少麻醉药用量,维持手术期间生命体征稳定,减少应激反应,调节机体免疫。其中2 Hz/100 Hz电针频率的镇痛效果最好,2 Hz电针频率在减少围手术期应激的作用最好。Objective To explore the application effects of different electroacupuncture frequencies on acupuncture anesthesia of patients undergoing pneumonectomy.Methods A total of 108 patients who underwent pneumonectomy were selected and randomly divided into 4 groups,group A,group B,group C and group D,with 27 cases in each group.All patients were given general anesthesia.Group A was given sham acupuncture,and groups B,group C and group D were given electroacupuncture at acupoints.The electroacupuncture frequency was 2 Hz in group B,100 Hz in group C and 2 Hz/100 Hz in group D.The intraoperative additional doses of anesthetics,vital signs,levels of adrenaline and cortisol,and T lymphocyte subset CD4+/CD8+ration were recorded.Results(1)The additional dose of fentanyl was decreased in groups B,C and D compared with that in group A(P<0.05).The additional dose of fentanyl was decreased in group D compared with that in groups B and C(P<0.05).(2)There was no significant difference in the additional dose of propofol among the 4 groups and the difference was not statistically significant(P>0.05).(3)During anesthesia induction,the mean arterial pressure and respiratory rate in groups B,group C and group D were significantly lower than those in group A(P<0.05).(4)Compared with group A,the levels of adrenaline during operation were lower in groups B,groupC,and group D(P<0.05);compared with group C and group D,the levels of adrenaline during operation were lower in group B(P<0.05).(5)Compared with group A,the levels of cortisol during operation were lower in groups B,C,and D(P<0.05);compared with group C,the levels of cortisol were lower during operation(P<0.05).(6)During surgery,the CD4+/CD8+in groups B,group C,and group D were higher than those in group A(P<0.05).(7)There were no significant differences in general anesthesia-related complications between the 4 groups,and the difference was not statistically significant(P>0.05).No acupuncture adverse reactions occurred.During operation,the CD4+/CD8+in groups B,C and D was smaller

关 键 词：肺切除术 全身麻醉 针刺麻醉 电针频率 应激反应 免疫功能 

分 类 号：R246.2[医药卫生—针灸推拿学]