经皮穴位电刺激联合超声引导下胸椎旁神经阻滞在肺癌胸腔镜根治术中的应用  

Application of percutaneous acupoint electrical stimulation combined with ultrasound-guided thoracic paravertebral nerve block in thoracoscopic radical resection of lung cancer

作　　者：雷钧[1] 曹珲[1] 崔彦[1] 夏梦[1] LEI Jun;CAO Hun;CUI Yan;XIA Meng(Nanjing Chest Hospital,Nanjing 210000)

机构地区：[1]江苏省南京市胸科医院,江苏南京210000

出　　处：《湖北中医药大学学报》2024年第4期87-89,共3页Journal of Hubei University of Chinese Medicine

基　　金：江苏省南京市卫生科技发展专项资金项目(项目编号:YKK23137)。

摘　　要：目的观察经皮穴位电刺激(TEAS)联合超声引导下胸椎旁神经阻滞(UTPVB)在肺癌胸腔镜根治术中的应用。方法将我院65例行肺癌胸腔镜根治术的患者随机分为对照组33例与治疗组32例。对照组采用UTPVB治疗,治疗组用采用TEAS联合UTPVB治疗。比较两组术后3h、48h静息及咳嗽疼痛模拟量表(VAS)评分;术前、术后48 h糖类抗原(CA)125、癌胚抗原(CEA)含量;术前、术后48 h CD4^(+)T、CD8^(+)T含量;麻醉诱导前、术后6 h收缩压(SBP)、舒张压(DBP)、心率(HR);术后48 h恶心呕吐率、认知障碍率及病情恢复时间。结果术后48 h,两组静息及咳嗽VAS评分低于术后3 h,治疗组静息及咳嗽VAS评分均低于术后同期对照组(P<0.05);两组CA125、CEA含量低于术前(P<0.05),但两组CA125、CEA含量比较无统计学意义(P>0.05);两组CD4^(+)T含量低于术前,CD8^(+)T含量高于术前,且治疗组CD4^(+)T含量高于对照组,CD8^(+)T含量低于对照组(P<0.05);术后6h,两组SBP、DBP、HR低于麻醉诱导前,治疗组SBP、DBP、HR高于对照组(P<0.05);治疗组恶心呕吐率、认知障碍率低于对照组(P<0.05);治疗组苏醒、排气、进食、下床、住院时间均短于对照组(P<0.05)。结论TEAS联合UTPVB应用于肺癌胸腔镜根治术中,可明显降低静息和咳嗽疼痛,改善细胞免疫损伤,维持生命体征,防止恶心呕吐和认知障碍发生,加速康复。Objective To observe the effect of percutaneous electrical stimulation(TEAS)combined with ultrasoundguided thoracic paravertebral nerve block(UTPVB)in thoracoscopic radical resection of lung cancer.Methods A total of 65cases of radical thoracoscopic radical resection of lung cancer patients were randomly divided into control group(33 cases)and treatment group(32 cases).Control group was treated with UTPVB,and treatment group was treated with TEAS on the basis of control group.The scores of Rest and Cough Pain Simulation Scale(VAS)at 3 h and 48 h after surgery,the contents of carbohydrate antigen(CA)125 and carcinoembryonic antigen(CEA)before and 48 h after surgery,the contents of CD4^(+)T and CD8^(+)T at 48 h before and after operation,systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)before anesthesia induction and 6 h after operation,the rates of nausea and vomiting and cognitive impairment at 48 h after operation,and the recovery time in the two groups were compared.Results 48 h after surgery,the VAS scores in both groups were lower than those at 3 h after surgery;the VAS scores in treatment group were lower than those in control group in the same period after surgery(P<0.05);the levels of CA125 and CEA in both groups were lower than before surgery(P<0.05),but there was no statistically significant difference in the levels of CA125 and CEA between the two groups(P>0.05);the CD4^(+)T content in both groups was lower than before surgery,and was higher than before surgery,and was higher in treatment group than control group,while the CD8^(+)T content was lower than that in control group(P<0.05);6 h after surgery,SBP,DBP,and HR in both groups were lower than before surgery,and were higher in treatment group than control group(P<0.05);the rates of nausea,vomiting,and cognitive impairment in treatment group were lower than control group(P<0.05);treatment group had shorter awakening,exhaust,eating,getting out of bed time and hospital stay than control group(P<0.05).Conclusion TEAS combined w

关 键 词：肺癌 胸椎旁神经阻滞 超声引导下 胸腔镜根治术 经皮穴位电刺激 

分 类 号：R246.1[医药卫生—针灸推拿学]