经皮穴位电刺激内关穴对全麻诱导后低血压的预防作用  

Preventive effect of percutaneous electrical stimulation at Neiguan Point on hypotension induced by general anesthesia

作　　者：马拥 钟庆玲 MA Yong;ZHONG Qing-ling(Department of Anesthesiology,Guangzhou University of Traditional Chinese Medicine Shenzhen Hospital(Futian),Shenzhen 518034,Guangdong,CHINA;Preventive Treatment of Disease,Guangzhou University of Traditional Chinese Medicine Shenzhen Hospital(Futian),Shenzhen 518034,Guangdong,CHINA)

机构地区：[1]广州中医药大学深圳医院(福田)麻醉科,广东深圳518034 [2]广州中医药大学深圳医院(福田)治未病科,广东深圳518034

出　　处：《海南医学》2024年第12期1731-1735,共5页Hainan Medical Journal

摘　　要：目的探究经皮穴位电刺激内关穴对全麻诱导后低血压的预防作用。方法前瞻性选择2022年4~10月在广州中医药大学深圳医院择期行全身麻醉气管插管下手术的80例患者进行研究,按照随机数表法分为观察组和对照组,每组40例。观察组患者于术前10 min开始接受经皮内关穴电刺激,持续30 min,对照组患者仅在同样部位连接电极但不予电刺激。分别于患者麻醉前10 min(T1)、麻醉后气管插管后3 min(T2)、30 min(T3)后记录两组患者血流动力学指标[心率(HR)、舒张压(DBP)、收缩压(SBP)、平均动脉压(MAP)],并比较两组患者治疗期间的羟胺用药情况、输液量和尿量情况;同时采用超声监测两组患者颈动脉情况,记录并比较颈动脉校正血流时间(FTc)及颈动脉峰流速呼吸变异度(ΔVpeak);术后随访24 h,比较两组患者的术后恢复情况。结果组间比较:T1时,两组患者的HR、DBP、SBP、MAP比较差异均无统计学意义(P>0.05),T2、T3时,观察组患者的HR、DBP、SBP、MAP明显高于对照组,差异均有统计学意义(P<0.05);组内比较:两组患者T3的HR、DBP、SBP、MAP明显高于T2,T2的HR、DBP、SBP、MAP明显高于T1,差异均有统计学意义(P<0.05)。组间比较:T1时,两组患者的FTc、ΔVpeak比较差异均无统计学意义(P>0.05),T2、T3时,观察组患者的FTc、ΔVpeak水平明显低于对照组,差异均有统计学意义(P<0.05);组内比较:两组患者T3的FTc、ΔVpeak明显高于T1,T2的FTc、ΔVpeak明显高于T2,差异均有统计学意义(P<0.05)。观察组患者的去间羟胺用药率为7.5%,明显低于对照组的47.50%,差异有统计学意义(P<0.05),但两组患者的输液量、尿量比较差异均无统计学意义(P>0.05);术后24 h,观察组患者的恶心呕吐、头晕的发生率分别为10.00%、2.50%,明显低于对照组的62.50%、15.00%,差异均有统计学意义(P<0.05),但两组患者的胸闷、呼吸困难发生率比较差异均无统计学意义(P>0.05)。结论经皮Objective To explore the preventive effect of percutaneous electrical stimulation at Neiguan point on hypotension induced by general anesthesia.Methods A total of 80 patients scheduled for tracheal intubation surgery under general anesthesia in Guangzhou University of Traditional Chinese Medicine Shenzhen Hospital(Futian)from April to October 2022 were prospectively selected for this study,which were divided into an observation group and a control group according to random number table method,with 40 patients in each group.Patients in the observation group began to receive percutaneous electrical stimulation at Neiguan points 10 minutes before surgery for 30 min,while patients in the control group were only connected with electrodes at the same site without electrical stimulation.Hemodynamic indexes[heart rate(HR),diastolic blood pressure(DBP),systolic blood pressure(SBP),and mean arterial pressure(MAP)]were recorded at 10 min(T1)before anesthesia,3 min(T2)and 30 min(T3)after endotracheal intubation after anesthesia,respectively.The use of hydroxylamine,infusion volume,and urine volume during treatment were compared between the two groups.At the same time,the carotid artery conditions of the two groups were monitored by ultrasound,and the corrected carotid flow time(FTc)and the respiratory variability of carotid peak flow rate(ΔVpeak)were recorded and compared.After postoperative follow-up of 24 hours,the postoperative recovery were compared between the two groups.Results Inter-group comparison:at T1,there were no statistically significant differences in HR,DBP,SBP,and MAP between the two groups(P>0.05);at T2 and T3,HR,DBP,SBP,and MAP in the observation group were significantly higher than those in the control group(P<0.05).Intra-group comparison:HR,DBP,SBP,and MAP of T3 were significantly higher than those at T2,and HR,DBP,SBP,and MAP of T2 were significantly higher than those at T1,with statistically significant differences(P<0.05).Inter-group comparison:at T1,there were no statistically significant difference

关 键 词：全麻诱导后低血压 经皮穴位电刺激 内关穴 颈动脉校正血流时间 颈动脉峰流速呼吸变异度 

分 类 号：R614.2[医药卫生—麻醉学]