经皮穴位电刺激对七氟醚全麻患者术后嗅觉记忆障碍及血浆褪黑素的影响  

Effect of transcutaneous electrical acupoint stimulation on postoperative olfactory memory disorder and plasma melatonin in patients with general anesthesia of sevoflurane

作　　者：黄健 高鸿 曹莹 周菁 任益民 席特 高华琳 王安琦 周微 HUANG Jian;GAO Hong;CAO Ying;ZHOU Jing;REN Yi-min;XI Te;GAO Hua-lin;WANG An-qi;ZHOU Wei(departm ent of Anesthesiology,Third People's Hospital of Guizhou Province,Guiyang 550008,China;Department of Anesthesiology,Third Affiliated Hospital of Guizhou Medical University,Duyun 558000;Department of Anesthesiology,Second People's Hospital of Guiyang City)

机构地区：[1]贵州省第三人民医院麻醉科,贵阳550008 [2]贵州医科大学第三附属医院麻醉科,都匀558000 [3]贵阳市第二人民医院麻醉科

出　　处：《中国针灸》2020年第3期243-246,共4页Chinese Acupuncture & Moxibustion

基　　金：贵州省中医药管理局科学技术基金项目:QZYY2017-032。

摘　　要：目的:观察经皮穴位电刺激(TEAS)对七氟醚全麻患者术后嗅觉记忆障碍的作用,并探讨其可能作用机制。方法:将40例拟择期在全身麻醉下行妇科、泌尿科等手术的患者随机分为观察组和对照组,每组20例。观察组在麻醉诱导前10 min于迎香、印堂行经皮穴位电刺激(疏密波,2 Hz/100 Hz),至手术结束;对照组直接行全身麻醉。于治疗前、手术开始后30 min和手术结束时记录两组患者平均动脉压(MAP)、心率(HR)和血氧饱和度(SpO2)变化;于治疗前(T0)和麻醉结束后Aldrete评分达10分时(T1)采用康涅狄格化学感觉临床研究中心(CCCRC)嗅觉功能检查法评估嗅觉识别分数,并采用ELISA法测定外周静脉血血浆褪黑素的浓度。结果:两组患者各时间点MAP、HR、SpO2组内、组间比较差异均无统计学意义(P>0.05)。与T0时间点比较,观察组T1时间点嗅觉识别分数、血浆褪黑素浓度差异均无统计学意义(P>0.05),对照组嗅觉识别分数下降,血浆褪黑素浓度降低(P<0.05)。T1时间点观察组嗅觉识别分数、血浆褪黑素浓度高于对照组(P<0.05)。结论:经皮穴位电刺激可以改善七氟醚全麻患者术后嗅觉记忆障碍,其作用机制可能与增加血浆褪黑素浓度有关。Objective To observe the effect of transcutaneous electrical acupoint stimulation(TEAS) on postoperative olfactory memory disorder in patients with general anesthesia of sevoflurane and to explore its possible mechanism. Methods Forty patients who were scheduled to have gynecological and urological procedures under general anesthesia were randomly divided into an observation group and a control group, 20 cases in each group. The patients in the observation group were treated with TEAS(dilatational wave, 2 Hz/100 Hz) at Yingxiang(LI 20) and Yintang(GV 29) 10 min before anesthesia induction until the end of operation;the patients in the control group received general anesthesia directly. The changes of mean arterial pressure(MAP), heart rate(HR) and blood oxygen saturation(SpO2) were recorded before treatment, 30 min after operation and at the end of operation;smell identification score was measured by Connecticut Chemosensory Clinical Research Center(CCCRC) olfactory test before treatment(T0) and when Aldrete recovery score reached 10 points at the end of anesthesia(T1);the concentration of melatonin in plasma was measured by ELISA method in the two groups. Results The between-group differences and within-group differences of MAP, HR and SpO2 were not significant at each time point(P>0.05). Compared with T0, the score of smell identification and plasma concentration of melatonin were not significantly different at T1 in the observation group(P>0.05), however, the score of smell identification and plasma concentration of melatonin were reduced in the control group(P<0.05). At T1, the score of smell identification and plasma concentration of melatonin in the observation group were higher than those in the control group(P<0.05). Conclusion TEAS could improve the postoperative olfactory memory disorder in patients with general anesthesia of sevoflurane, and its mechanism may be related to the increase of plasma concentration of melatonin.

关 键 词：嗅觉记忆 七氟醚全麻 经皮穴位电刺激 褪黑素 

分 类 号：R246.6[医药卫生—针灸推拿学]