电针内关穴对肺叶切除术患者单肺通气时肺功能的影响  

Effect of electroacupuncture at Neiguan(PC 6)on pulmonary function during one-lung ventilation in patients with lobectomy

作　　者：丁艺[1] 粟胜勇[1] 林雅丽[1] 韦懿桐[1] 蔡元春[1] 石俊丹 高斯莉 莫科林[1] 卓金义 DING Yi;SU Sheng-yong;LIN Ya-li;WEI Yi-tong;CAI Yuan-chun;SHI Jun-dan;GAO Si-li;MO Ke-lin;ZHUO Jin-yi(Department of Anesthesiology,First Affiliated Hospital of Guangxi University of CM,Nanning 530023,China)

机构地区：[1]广西中医药大学第一附属医院麻醉科,南宁530023

出　　处：《中国针灸》2021年第6期598-602,共5页Chinese Acupuncture & Moxibustion

基　　金：广西自治区中医药局自筹经费科研课题项目:GZZC2019050。

摘　　要：目的:观察电针内关穴对肺叶切除术患者单肺通气(OLV)时肺功能的保护作用,并探讨其机制。方法:将60例行肺叶切除术患者随机分为观察组和对照组,每组30例。对照组给予全麻,手术开始时行OLV,术毕胸腔排除气体后行双肺通气;观察组在对照组基础上于麻醉诱导前30 min行电针刺激内关(疏密波,2 Hz/100 Hz)直至术毕。分别于术前(T_(0))、OLV 30 min(T_(1))、OLV 60 min(T_(2))、术毕(T_(3)),观察两组肺功能指标[动脉血氧分压(PaO_(2))、氧合指数(OI)、肺顺应性(CL)、呼吸指数(RI)]及血清超氧化物歧化酶(SOD)、丙二醛(MDA)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平;比较两组并发症总发生率、术后48 h自控镇痛泵按压次数及住院时间。结果:与T_(0)时比较,两组患者T_(1)、T_(2)及T_(3)时PaO_(2)、OI、CL及血清SOD降低(P<0.05),观察组高于对照组(P<0.05),两组患者T_(1)、T_(2)及T_(3)时RI及血清MDA、IL-6、TNF-α升高(P<0.05),观察组低于对照组(P<0.05);观察组并发症总发生率低于对照组[3.3%(1/30)vs 23.3%(7/30),P<0.05];观察组术后48 h自控镇痛泵按压次数及住院时间均少于对照组(P<0.05)。结论:电针内关对肺叶切除术OLV所致肺损伤有保护效应,其机制可能与改善机体氧化应激和炎性反应水平有关。Objective To observe the protective effect of electroacupuncture(EA)at Neiguan(PC 6)on pulmonary function during one-lung ventilation(OLV)in patients with lobectomy,and explore its action mechanism.Methods Sixty patients with lobectomy were randomly divided into an observation group and a control group,30 cases in each one.The patients in the control group were treated with general anesthesia,and OLV was given when surgery began;when the surgery finished,air was removed from the thoracic cavity and two-lung ventilation was performed.On the basis of the treatment in the control group,the patients in the observation group were treated with EA(disperse-dense wave,2 Hz/100 Hz of frequency)at Neiguan(PC 6)30 min before anesthesia induction until the end of the surgery.The pulmonary function indexes[arterial partial pressure of oxygen(PaO_(2)),oxygenation index(OI),compliance of lung(CL),respiratory index(RI)]and serum levels of superoxide dismutase(SOD),malondialdehyde(MDA),interleukin 6(IL-6)and tumor necrosis factorα(TNF-α)were observed before surgery(T_(0)),30 min into OLV(T_(1)),60 min into OLV(T_(2))and after operation(T_(3)).The total incidence of complications,pressing times of postoperative patient-controlled analgesia pump in 48 h after surgery and hospital stay were compared between the two groups.Results Compared with T_(0),the PaO_(2),OI,CL and serum SOD at T_(1),T_(2) and T_(3) in the two groups were decreased(P<0.05),and those in the observation group were higher than those in the control group(P<0.05).The RI and serum levels of MDA,IL-6,TNF-αat T_(1),T_(2) and T_(3) in the two groups were increased,and those in the observation group were lower than those in the control group(P<0.05).The total incidence of complications in the observation group was lower than that in the control group[3.3%(1/30)vs 23.3%(7/30),P<0.05].The pressing times of postoperative patient-controlled analgesia pump in 48 h after surgery and hospital stay in the observation group were less than those in the control group(P<0.05).Co

关 键 词：肺损伤 单肺通气 电针 穴 内关 肺功能 氧化应激 炎性反应 

分 类 号：R246.2[医药卫生—针灸推拿学]