穴位预埋线对全麻腹腔镜妇科手术患者自主神经和胃肠功能的影响  

Effect of acupoint pre-embedding thread on autonomic nervous system and gastrointestinal function in patients undergoing gynecological laparoscopic surgery under general anesthesia

作　　者：夏海燕 张建友 偶鹰飞[2] 王鼐超 李菲菲 郑重[4] XIA Haiyan;ZHANG Jianyou;OU Yingfei;WANG Naichao;LI Feifei;ZHENG Zhong(Department of Anesthesiology,Affiliated Hospital of Yangzhou University,Yangzhou 225000,China)

机构地区：[1]扬州大学附属医院麻醉科,225000 [2]江苏省太仓市第一人民医院康复科 [3]江苏省太仓市第一人民医院普外科 [4]江苏省太仓市第一人民医院麻醉科

出　　处：《临床麻醉学杂志》2024年第7期699-703,共5页Journal of Clinical Anesthesiology

基　　金：扬州市社会发展计划项目(YZ2022109);扬州市卫健委医学科研面上项目(2023-2-06)。

摘　　要：目的观察多组穴位预埋线对全麻腹腔镜妇科手术患者自主神经和胃肠功能的影响。方法选择择期全麻下行腹腔镜妇科手术患者60例,年龄25~64岁,BMI 18.5~30.0 kg/m^(2),ASAⅠ或Ⅱ级。采用随机数字表法将患者分为两组:对照组(C组)和穴位预埋线组(M组),每组30例。M组于术前1 d给予患者内关、三阴交、膈俞、厥阴俞、胃俞共5组10个穴位进行预埋线,C组术前不进行穴位埋线操作。记录麻醉诱导前5 min、气管插管后即刻、建立气腹后即刻、气腹后10、20、30 min、拔除气管导管时的HR、MAP、低频功率标准化值(LF)、高频功率标准化值(HF)和LF/HF。记录术后首次肛门排气、排便时间和术后48 h内恶心呕吐发生情况。分别于术前1 d和术后24 h检测血清胃动素和胃泌素浓度。结果与C组比较,M组气腹后10、20、30 min的HR明显减慢,MAP、LF和LF/HF明显降低,HF明显升高(P<0.05);M组术后首次肛门排气和排便时间明显缩短(P<0.05),术后24 h内恶心呕吐发生率明显降低(P<0.05),术后24 h血清胃动素和胃泌素浓度明显升高(P<0.05)。结论穴位组合预埋线可调节全麻腹腔镜妇科手术患者自主神经功能,有利于术后胃肠功能恢复,改善康复质量。Objective To explore the effects of multiple groups of acupoint pre-embedding thread on the autonomic nervous system and gastrointestinal function in patients undergoing gynecological laparoscopic surgery under general anesthesia.Methods Sixty patients,aged 25-64 years,BMI 18.5-30.0 kg/m^(2),ASA physical statusⅠorⅡ,were selected for laparoscopic gynecological surgery under general anesthesia.Patients were divided into two groups using a random number table method:control group(group C)and acupoint thread embedding group(group M),30 patients in each group.Patients in group M received thread embedding at 10 acupoints in 5 groups,including Neiguan,Sanyinjiao,Geshu,Jueyin,and Weishu on the day before surgery.Patients in group C did not undergo thread embedding at acupoints before surgery.The HR,MAP,normalized unit of low frequency(LF),normalized unit of high frequency(HF)and LF/HF were recorded at 5 minutes before anesthesia induction,immediately after tracheal intubation,immediately after establishing pneumoperitoneum,10,20,and 30 minutes after pneumoperitoneum,and when tracheal intubation was removed.Motilin and gastrin concentrations in serum were measured on the day before surgery and 24 hours after surgery.The time of first postoperative exhaust and defecation,as well as the occurrence of nausea and vomiting within 48 hours after surgery were recorded.Results Compared with group C,the HR was significantly lower,and the MAP,the LF and LF/HF in group M were significantly reduced at 10,20,and 30 minutes after pneumoperitoneum,while HF was significantly increased(P<0.05).The first postoperative time of exhaust and defecation in group M was significantly shortened(P<0.05),and the incidence of nausea and vomiting within 24 hours after surgery was significantly reduced(P<0.05).The concentrations of motilin and gastrin in serum of group M were significantly increased 24 hours after surgery(P<0.05).Conclusion The combination of acupoints and pre-embedding thread can regulate the autonomic nervous function of patients

关 键 词：穴位埋线 自主神经 胃肠功能 心率变异性 术后恶心呕吐 

分 类 号：R614[医药卫生—麻醉学]