经皮穴位电刺激对骨科全麻手术后患者血流动力学的影响  

Impact of Acupoint Electrical Stimulation on Hemodynamics in Patients After Orthopedic Surgery Under General Anesthesia

作　　者：王麒[1] 柯海[1] 丁玲玲 于波[1] 陆斌[1] 孙蔚明 WANG Qi;KE Hai;DING Lingling;YU Bo;LU Bin;SUN Weiming(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010

出　　处：《上海针灸杂志》2022年第2期139-144,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：首都医科大学基础临床科研合作课题(17JL84)。

摘　　要：目的观察经皮穴位电刺激对骨科全麻患者血流动力学的影响及其对下肢深静脉血栓(DVT)的预防作用。方法纳入80例下肢骨折且接受骨科全麻手术的患者,采用随机数字表法分为观察组和对照组,每组40例。两组均接受常规治疗,观察组在此基础上加用经皮穴位电刺激疗法。观察两组治疗前后凝血指标[纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和D-二聚体(D-dimer)]和下肢血液流变学相关指标[血浆黏度、全血黏度值(高切和低切)、血小板计数、血小板黏附率以及红细胞压积]的变化。比较两组治疗前后下肢股总静脉、股深静脉、腘静脉以及胫后静脉血流流速变化。比较两组治疗期间DVT的阳性率。结果与治疗前比较,两组治疗后PT、APTT均延长,D-dimer水平明显下降,差异均具有统计学意义(P<0.05);观察组治疗后上述指标均优于对照组(P<0.05)。与治疗前比较,两组治疗后血浆黏度、全血黏度值(高切和低切)、血小板黏附率以及红细胞压积水平、血小板计数均明显下降,差异均具有统计学意义(P<0.05);两组治疗后股总静脉、股深静脉、腘静脉以及胫后静脉血流流速均明显改善(P<0.05);观察组治疗后上述指标均优于对照组(P<0.05)。观察组治疗期间DVT的阳性率低于对照组(P<0.05)。结论在常规治疗基础上,经皮穴位电刺激疗法可显著改善骨科全麻患者血流动力学,且对下肢深静脉血栓具有一定的预防作用。Objective To observe the impact of acupoint electrical stimulation on hemodynamics in patients after orthopedic surgery under general anesthesia and its effect in preventing deep vein thrombosis(DVT).Method Eighty patients who received orthopedic surgery for lower-limb fracture under general anesthesia were divided into an observation group and a control group using the random number table method,with 40 cases in each group.The conventional intervention was offered to both groups after the surgery,while the observation group was given additional acupoint electrical stimulation therapy.Before and after the treatment,the coagulation indexes[fibrinogen(FIB),prothrombin time(PT),activated partial thromboplastin time(APTT),and D-dimer(D-D)]and lower-limb hemodynamics indicators[plasma viscosity,whole blood viscosity(high shear and low shear),platelet count,platelet adhesion rate,and hematocrit]were observed for the two groups.The blood flow velocities of the common femoral vein,deep femoral vein,popliteal vein,and posterior tibial vein were compared before and after the treatment,as well as the positive rate of DVT during the treatment.Result The PT and APTT were extended,and the D-D level significantly dropped after the treatment in both groups(P<0.05);the observation group achieved better results comparing the indexes mentioned above(P<0.05).The levels of plasma viscosity,whole blood viscosity(high shear and low shear),platelet adhesion rate,hematocrit,and platelet count decreased significantly after the treatment in both groups(P<0.05);the blood flow velocities of the common femoral vein,deep femoral vein,popliteal vein,and posterior tibial vein were notably improved(P<0.05);the observation group was superior to the control group comparing the indicators mentioned above(P<0.05).During the treatment,the positive DVT rate was lower in the observation group than in the control group(P<0.05).Conclusion Based on the conventional intervention,acupoint electrical stimulation therapy can improve the hemodynamics in patient

关 键 词：穴位疗法 经皮神经电刺激 骨折 术后 全身麻醉 血流动力学 深静脉血栓 

分 类 号：R246.2[医药卫生—针灸推拿学]