经皮穴位电刺激对腹腔镜结直肠癌根治术后患者早期认知功能障碍及血清炎症因子、胃肠激素的影响  

Effect of transcutaneous electrical acupoint stimulation on early cognitive dysfunction and serum inflammatory factors and gastrointestinal hormone in patients underwent laparoscopic radical resection of colorectal cancer

作　　者：李亦凡 童贻捷 LI Yifan;TONG Yijie(Department of Anesthesiology,Jiading Hospital of Traditional Chinese Medicine,Shanghai 201800)

机构地区：[1]上海市嘉定区中医医院麻醉科,上海201800

出　　处：《河北中医》2023年第11期1867-1871,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的 观察经皮穴位电刺激对腹腔镜结直肠癌根治术后患者早期认知功能障碍及血清炎症因子、胃肠激素的影响。方法 将95例拟行择期腹腔镜结直肠癌根治术的患者随机分为治疗组和对照组,所有患者均予常规全身静脉麻醉,对照组47例同时予穴位贴电极片行假刺激处理,治疗组48例予经皮穴位电刺激治疗。比较2组手术相关指标,比较2组术前、术后24 h血清炎症因子[C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)]、胃肠激素[胃动素(MTL)、胃泌素(GAS)、血管活性肽(VIP)、胆囊收缩素(CCK)]变化情况,术后3天采用简易精神状态量表(MMSE)评价2组患者认知功能障碍发生情况。结果 治疗组术后首次排气时间、首次排便时间、术后住院时间均短于对照组(P<0.05)。术后24 h,2组血清CRP、PCT、IL-6、TNF-α水平均高于本组术前(P<0.05),但治疗组均低于对照组(P<0.05)。术后24 h,2组血清MTL、GAS、VIP、CCK水平均低于本组术前(P<0.05),但治疗组均高于对照组(P<0.05)。术后3天,治疗组认知功能障碍发生率为18.75%(9/48),对照组为38.30%(18/47),治疗组低于对照组(P<0.05)。结论 经皮穴位电刺激治疗能够促进腹腔镜结直肠癌根治术后患者术后康复,减少术后早期认知功能障碍的发生,可能与拮抗炎症反应、调节胃肠激素等因素有关。Objective To observe the effect of transcutaneous electrical acupoint stimulation(TEAS)on early cognitive dysfunction and serum inflammatory factors and gastrointestinal hormone in patients underwent laparoscopic radical resection of colorectal cancer(LRRCC).Methods A total of 95 patients underwent elective LRRCC were randomly assigned into the treatment group(n=48)and the control group(n=47).All patients were managed by routine general intravenous anesthesia,and those in the control group and the treatment group were additionally treated with sham acupuncture by applying electrode to acupoints and TEAS,respectively.The aim was to compare surgical related indicators,serum inflammatory factors(C-reactive protein[CRP],procalcitonin[PCT],interleukin-6[IL-6],tumor necrosis factorα[TNF-α])and gastrointestinal hormones(motilin[MTL],gastrin[GAS],vasoactive intestinal peptide[VIP],cholecystokinin[CCK])preoperatively and at 24 hours postoperatively.The 3-day Mini-Mental State Examination(MMSE)were performed for cognitive dysfunction.Results The postoperative first exhaust time,first defecation time,postoperative length of stay were significantly shorter in the treatment group than in the control group(P<0.05).CRP,PCT,IL-6,TNF-αat 24 hours postoperatively in the both groups were significantly increased(P<0.05),which were significantly decreased in the treatment group compared with the control group(P<0.05).MTL,GAS,VIP,CCK at 24 hours postoperatively in the both groups were significantly decreased(P<0.05),which were significantly higher in the treatment group than in the control group(P<0.05).The incidence of cognitive dysfunction at 3 days postoperatively in the treatment group was lower than that in the control group(18.75%[9/48]vs 38.30%[18/47],[P<0.05],respectively).Conclusion For patients underwent LRRCC,TEAS can promote postoperative recovery and reduce postoperative early cognitive dysfunction by antagonizing inflammatory responses and regulating gastrointestinal hormones.

关 键 词：结直肠肿瘤 腹腔镜 电刺激疗法 穴位疗法 术后认知并发症 炎性因子 胃肠激素类 

分 类 号：R735.3[医药卫生—肿瘤] R245.97[医药卫生—临床医学]