经皮多穴位电刺激对宫颈癌根治术患者拔管应激及麻醉后监测治疗室恢复质量的影响  

Effect of percutaneous multi-acupoint electrical stimulation on extubation stress and postanesthesia care unit recovery quality in patients undergoing radical cervical cancer surgery

作　　者：郑洁 汪信 何丽 綦欣竹 张英 ZHENG Jie;WANG Xin;HE Li;QI Xinzhu;ZHANG Ying(Department of Anesthesiology,Affiliated Hospital of Traditional Chinese medicine,Southwest Medical University,Luzhou,Sichuan,646000,China)

机构地区：[1]西南医科大学附属中医医院麻醉科,四川泸州646000

出　　处：《当代医学》2023年第8期19-22,共4页Contemporary Medicine

摘　　要：目的探讨经皮多穴位电刺激对宫颈癌根治术患者拔管应激反应及麻醉后监测治疗室(PACU)恢复质量的影响。方法选取2018年6月至2020年6月于本院拟行宫颈癌根治术的90例患者作为研究对象,按随机单盲法分为空白对照组(C组)、经皮内关、合谷多穴位电刺激组(T组)、右美托咪定组(D组),每组30例。比较3组缝皮时(T_(1))、拔管前即刻(T_(2))、拔管即刻(T3)、拔管后5 min(T_(4))的血流动力学变化,T3时静脉血皮质醇、血管紧张素Ⅱ水平,PACU镇痛、镇静评分及术后不良反应发生情况。结果3组平均动脉压和心率组间、交互比较差异有统计学意义(P<0.05)。组间比较:T_(2)、T_(3)、T_(4)时,D组和T组平均动脉压和心率均低于C组(P<0.05);组内比较:C组T_(2)、T_(3)和T4时刻平均动脉压和心率高于T1时(P<0.05),D组T_(3)时平均动脉压、心率均高于T_(1)时(P<0.05),T组T_(3)时平均动脉压及T_(2)、T_(3)、T_(4)时心率均高于T1时(P<0.05)。T_(3)时,C组皮质醇、血管紧张素Ⅱ水平高于T组和D组,差异有统计学意义(P<0.05),T组和D组比较差异无统计学意义。T组和D组在恢复室视觉模拟评分法(VAS)评分、Ramsay评分均低于C组,差异有统计学意义(P<0.05)。T组和D组术后恶心呕吐及烦躁发生率明显低于C组,差异有统计学意义(P<0.05)。结论经皮多穴位电刺激可有效降低宫颈癌根治术患者拔管期的应激反应、维持血流动力学平稳,使患者苏醒平顺、镇静适度,提高PACU恢复质量。Objective To explore the effect of percutaneous multi-acupoint electrical stimulation on extubation stress response and postoperative nausea and vomiting in patients undergoing radical cervical cancer surgery.Methods A total of 90 patients who were scheduled to undergo radical surgery for cervical cancer in our hospital from June 2018 to June 2020 were selected as the research subjects,and they were randomly divided into three groups according to single blind method:blank control group(group C),transdermal Neiguan,Hegu multi-point electrical stimulation group(group T),and dexmedetomidine group(group D),with 30 cases in each group.Hemodynamic changes at suture(T_(1)),immediately before extubation(T_(2)),immediately after extubation(T_(3)),5 min after extubation(T_(4)),venous cortisol and angiotensinⅡlevels at T_(3),PACU analgesic and sedation scores,and postoperative adverse reactions were compared among the three groups.Results There were significant differences of mean arterial pressure and heart rate in inter-group and ininteractive comparisons among the three groups(P<0.05).inter-group comparison:the mean arterial pressure and heart rate T_(2),T_(3)and T_(4)in group D and group T were lower than those in group C(P<0.05);intra-group comparison:the mean arterial pressure and heart rate at T_(2),T_(3)and T_(4)in group C were higher than T_(1)(P<0.05);the mean arterial pressure and heart rate at T_(3)in group D were higher than T_(1)(P<0.05);the mean arterial pressure at T_(3)and heart rate at T_(2),T_(3)and T_(4)in group T were higher than T_(1)(P<0.05).At T_(3),the concentrations of cortisol and angiotensinⅡin group C were higher than those in group T and group D,and the difference was statistically significant(P<0.05),but there was no statistical significance between group T and group D.The visual analogue scale(VAS)score and Ramsay score in the recovery room of group T and group D were lower than those of group C,and the differences were statistically significant(P<0.05).The incidence of postoperative naus

关 键 词：经皮多穴位电刺激 宫颈癌根治术 拔管应激 恶心呕吐 

分 类 号：R737.33[医药卫生—肿瘤]