电针联合右美托咪定对骨科老年患者术中应激的影响研究  

Study on the Effect of Electroacupuncture Combined with Dexmedetomidine on Intraoperative Stress in Elderly Orthopedic Patients

作　　者：严兆霞 周正清[1] 陈轶菁[1] 沈华[1] 陈瑜[1] 许华 YAN Zhao-xia;ZHOU Zheng-qing;CHEN Yi-jing;SHEN Hua;CHEN Yu;XU Hua(The Department of Anesthesiology,the Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,shanghai 200437)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院麻醉科,上海200437

出　　处：《实用中西医结合临床》2021年第4期1-3,8,共4页Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine

基　　金：上海市科学技术委员会科研计划项目(编号:16ZR1400500)。

摘　　要：目的:探讨电针联合右美托咪定对老年骨科患者术中应激的影响。方法:选取拟行手术治疗的老年下肢骨折患者56例为研究对象,采用随机数字表法分为单纯全麻组、电针复合全麻组(简称复合电针组)、右美托咪定复合全麻组(简称复合右美组)及电针联合右美托咪定复合全麻组(简称针药复合组),各14例。记录各组各时间点血压、心率、血氧饱和度等各项监护指标,术前、术后神经心理学指标(简易智力检查评分和疼痛视觉模拟评分)及各时间点血糖水平,术中心血管活性药物使用情况及患者住院天数。结果:术后各时间点针药复合组简易智力检查评分高于单纯全麻组(P<0.05);术后72h内,针药复合组疼痛评分低于其他三组(P<0.05);针药复合组术中循环系统指标及血糖水平更稳定;针药复合组术后意识恢复时间最短(P<0.05);四组术后呼吸恢复时间与住院天数比较,差异无统计学意义(P>0.05);四组心血管活性药物使用率比较,差异无统计学意义(P>0.05)。结论:老年骨科患者手术中采用电针联合右美托咪定治疗,能够稳定围术期血糖、术中循环系统指标水平,减少术后认知功能障碍发生率,显著降低术中应激水平。Objective:To explore the effect of electroacupuncture combined with dexmedetomidine on intraoperative stress in elderly orthopedic patients.Methods:56 Elderly patients with lower limb fractures were randomly divided into four groups(n=14):simple general anesthesia group,electroacupuncture compound general anesthesia group(abbreviated as compound electroacupuncture group),dexmedetomidine compound general anesthesia group(abbreviated as compound dexmedetomidine group),electroacupuncture and dexmedetomidine combined general anesthesia group(abbreviated as acupuncture and drug combination group).The blood pressure,heart rate,oxygen saturation and other monitoring indicators of each group at different time points,preoperative and postoperative neuropsychological indicators(Mini-Mental State Examination MMSE,Pain Visual Analogue Scale/Score VAS)and blood glucose at different time points,the use of vasoactive drugs in the operation center and the length of hospitalization days were recorded.Results:The MMSE value of the acupuncture and drug combination group at each time point were higher than that of the simple general anesthesia group(P<0.05);during 72 hours after operation,the pain VAS scores of the acupuncture and drug combination group was lower than that of the other three groups(P<0.05);the circulatory system indicators and blood glucose in the acupuncture and drug combination group were more stable;the postoperative recovery time of consciousness was the shortest in the acupuncture and drug combination group(P<0.05),but there was no difference between the four groups in terms of postoperative respiratory recovery time and hospitalization days(P>0.05);there was no difference in the use rate of cardiovascular active drugs among the four groups(P>0.05).Conclusion:Electroacupuncture combined with dexmedetomidine can stabilize perioperative blood glucose,intraoperative circulatory system indicator levels,reduce the incidence of postoperative cognitive dysfunction,and significantly reduce intraoperative stress level i

关 键 词：电针 右美托咪定 针药复合麻醉 老年 围术期 应激 

分 类 号：R614[医药卫生—麻醉学]