基于人工智能心率变异性监测设备探究“昼精夜暝”理论在胃癌术后康复中的临床意义  

Clinical Significance of“Enough Energy in Daytime and Relax at Night”Theory in Rehabilitation of Gastric Cancer Based on Artificial Intelligence HRV Monitoring Equipment

作　　者：沈丹丽 邓正明[1] 王刚[1] 成汇[1,2] 张小春 江志伟 SHEN Danli;DENG Zhengming;WANG Gang;CHENG Hui;ZHANG Xiaochun;JIANG Zhiwei(General Surgery,Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,Jiangsu,China;First Clinical Medical College,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京中医药大学附属医院普外科,江苏南京210029 [2]南京中医药大学第一临床医学院,江苏南京210029

出　　处：《辽宁中医杂志》2022年第8期1-5,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81704083);江苏省中医药管理局重点项目(ZD201903);江苏省中医院人才引进项目(grjj0250);江苏省研究生科研创新计划项目(SJCX20_0603)。

摘　　要：目的运用人工智能心率变异性(HRV)监测设备探究“昼精夜暝”与“昼不精,夜不暝”两种状态对胃癌患者术后自主神经昼夜节律和术后康复的影响。方法回顾性分析2019年6月—2020年12月于江苏省中医院普外科行择期机器人胃癌根治术的患者32例。根据患者术后第3天(记D3)的阿森斯失眠量表(AIS)评分,将AIS评分≤6分的患者划分为Ⅰ组(“昼精夜暝”组),将AIS评分>6分的患者划分为Ⅱ组(“昼不精,夜不暝”组)。观察两组患者的术前术后LF/HF、pNN50和rMSSD的昼夜节律的变化情况。对比分析两组患者术后住院天数、术后并发症、术后肛门首次通气/通便时间、疼痛评分(VAS评分)、炎症指标(WBC、CRP、IL-6和TNF-α)是否具有统计学差异。结果与Ⅱ组患者相比,Ⅰ组患者的pNN50、rMSSD和LF/HF在D3已基本恢复其昼夜节律。Ⅰ组患者D3的TNF-α水平[(2.65±2.49)pg/mL vs(6.07±4.82)pg/mL,P=0.03]和D3的VAS评分[(0.60±0.75)分vs(1.67±1.56)分,P=0.04]下降,术后肛门通气/通便时间[(20.56±5.14)h vs(31.01±11.08)h,P<0.01]提前,术后并发症发生率(2例vs 5例,P=0.02)降低,术后住院天数[(4.60±0.72)d vs(7.25±2.93)d,P<0.01]缩短。结论维持“昼精夜暝”状态有利于胃癌患者术后自主神经昼夜节律的恢复,减轻术后炎症反应,促进器官功能的康复。Objective To use artificial intelligence heart rate variability(HRV)monitoring equipment to explore the effects of“enough energy in daytime and relax at night”and“loss of energy in daytime and not relax at night”on the autonomic circadian rhythm and postoperative rehabilitation of patients with gastric cancer.Methods A retrospective analysis of 32 patients who underwent elective robotic radical gastric cancer surgery at the General Surgery Department of Jiangsu Provincial Hospital of Traditional Chinese Medicine from June 2019 to December 2020.According to the Assens Insomnia Scale(AIS)score on the 3 rd day after surgery(note D3),the patients with AIS score≤6 points were divided into group Ⅰ(“enough energy in daytime and relax at night”group),and the patients with AIS score>6 points were divided into group Ⅱ(“loss of energy in daytime and not relax at night”group).The changes of circadian rhythms of low frequency(LF)/high frequency(HF),pNN50 and root mean square of difference between adjacent normal cardiac cycles(rMSSD)of the two groups before and after surgery were observed.The postoperative hospital stay,postoperative complications,postoperative first anal ventilation/defecation time,pain scores(VAS scores),inflammatory indexes[white blood cells(WBC),C-reactive protein(CRP),interleukin 6(IL-6)and tumor necrosis factor-α(TNF-α)]were compared and analyzed between the two groups.Results Compared with those of the patients in group Ⅱ,the levels of pNN50,rMSSD and LF/HF of patients in group Ⅰ had basically recovered their circadian rhythms on D3.In group Ⅰ on D3,the TNF-α level[(2.65±2.49)pg/mL vs(6.07±4.82)pg/mL,P=0.03]and VAS scores[(0.60±0.75)points vs(1.67±1.56)points,P=0.04]were decreased,and postoperative anal ventilation/laxative time[(20.56±5.14)h vs(31.0±11.08)h,P<0.01]was earlier.The postoperative complication rate(2 cases vs 5 cases,P=0.02)was decreased and the postoperative hospital stay[(4.60±0.72)d vs(7.25±2.93)d,P<0.01]shortened.Conclusion Maintaining the state

关 键 词：昼精夜暝 心率变异性图谱 术后睡眠障碍 人工智能 加速康复外科 胃癌 

分 类 号：R735.2[医药卫生—肿瘤]