“交叉电项针”治疗重症脑出血后气管切开临床观察  

Clinical Observation of Cross Nape Electroacupuncture for Tracheotomy After Severe Cerebral Hemorrhage

作　　者：贾坤平 王秀珍[2] 吴建丽[1] 刘凯[2] 刘关平 裴思颖 蔡国锋[2] JIA Kun-ping;WANG Xiu-zhen;WU Jian-li;LIU Kai;LIU Guan-ping;PEI Si-ying;CAI Guo-feng(Heilongjiang University of Chinese Medicine,Harbin 150040,China;Hanan Hospital,Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150060,China)

机构地区：[1]黑龙江中医药大学,哈尔滨150040 [2]黑龙江中医药大学附属第二医院南院,哈尔滨150060

出　　处：《上海针灸杂志》2020年第3期300-304,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：黑龙江省自然科学基金项目(H2018066);黑龙江中医药大学科研基金(2019MS19)。

摘　　要：目的观察"交叉电项针"治疗重症脑出血后气管切开的临床疗效。方法将50例重症脑出血后气管切开留置套管患者随机分为交叉电项针组和常规治疗组,每组25例。常规治疗组予基础用药治疗和中风病常规针刺治疗,交叉电项针组在常规治疗组的基础上予"交叉电项针"治疗。分别记录两组患者气管切开插管封管时程,入院时和拔管后48 h动脉氧分压(PO2)和二氧化碳分压(PCO2)的变化以及入院时、治疗后1周、治疗后2周气管切开插管咳嗽反射分级量表评分(TCRGS)的变化。结果与常规治疗组比较,交叉电项针组患者的气管切开插管封管时程更短(P<0.01)。两组治疗后动脉PO2和PCO2均优于同组治疗前(P<0.05),组间比较差异无统计学意义(P>0.05)。两组治疗后1周TCRGS均低于入院时,治疗后2周均低于治疗后1周(P<0.01);与常规治疗组治疗后1周、治疗后2周比较,交叉电项针组TCRGS降低,差异均有统计学意义(P<0.01)。结论交叉电项针可缩短气切患者封管时程,有利于咳嗽反射功能的重塑;虽也可改善肺部换气功能,但较常规治疗未见明显优势。Objective To observe the clinical efficacy of cross nape electroacupuncture in treating tracheotomy aftersevere cerebral hemorrhage.Method Fifty patients who received tracheal tube indwelling after severe cerebralhemorrhage were randomized into a cross nape electroacupuncture group and a conventional treatment group,with 25cases in each group.The conventional treatment group was intervened by basic medication and conventionalacupuncture treatment for stroke,and the cross nape electroacupuncture group was given cross nape electroacupuncturein addition to the intervention given to the conventional treatment group.The tracheal tube indwelling duration,arterialPO2 and PCO2 at admission and 48 h after tracheal tube removal,and the scores of tracheotomy cough reflex gradingscore(TCRGS)at admission,1 week after treatment and 2 weeks after treatment in the two groups were recorded.Result Compared with the conventional treatment group,the tracheal tube indwelling duration was shorter in thecross nape electroacupuncture group(P<0.01).The arterial PO2 and PCO2 values were improved after treatment in thetwo groups(P<0.05),and the between-group difference was statistically insignificant(P>0.05).The TCRGS waslower at 1 week after treatment compared with that at admission in the two groups,and the score at 2 weeks aftertreatment was lower than that at 1 week after treatment(P<0.01);compared with the conventional treatment group,theTCRGS was lower in the cross nape electroacupuncture group at 1 week and 2 weeks after treatment,and the differences were statistically significant(P<0.01).Conclusion Cross nape electroacupuncture can shorten the tracheal tube indwelling duration and benefit the remodeling of cough reflex function;although it can also improve the pulmonary ventilation function,the advantage is not significant compared with conventional treatment.

关 键 词：针刺疗法 电针 针药并用 脑出血 气管切开术 咳嗽反射重塑 

分 类 号：R246.6[医药卫生—针灸推拿学]