内关穴注射地塞米松在骨科老年患者围手术期的应用效果  

Effect of Injection of Dexamethasone at Neiguan Acpoint in Elderly Orthopedic Patients during Perioperative Period

作　　者：王秋芬 蔡嘉琳 颜景佳 卢清旺 刘小红 WANG Qiufen;CAI Jialin;YAN Jingjia;LU Qingwang;LIU Xiaohong(Anesthesia Department,Jinjiang Municipal Hospital,Jinjiang 362200,China;不详)

机构地区：[1]晋江市医院(上海市第六人民医院福建医院)麻醉科,福建晋江362200

出　　处：《中国医学创新》2025年第5期131-136,共6页Medical Innovation of China

基　　金：福建中医药大学校管课题临床专项资助项目(XB2023198)。

摘　　要：目的:探究内关穴注射地塞米松在骨科老年患者围手术期的应用效果。方法:将2023年7月-2024年8月晋江市医院的120例老年骨科手术患者根据随机数字表法分为三组,各40例。A组于内关穴注射地塞米松,B组于内关穴注射生理盐水,C组静脉注射地塞米松。比较三组术前、术中5 min及术后即刻的血流动力学指标[平均动脉压(MAP)、心率(HR)],术前及术后24 h的心肌损伤指标[心肌肌钙蛋白I(cTnI)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)及脑钠肽(BNP)]、炎症指标[C反应蛋白(CRP)、白介素-6(IL-6)]及抗氧化指标[总抗氧化能力(TAC)、超氧化物歧化酶(SOD)、丙二醛(MDA)]。结果:术前三组的血流动力学指标、心肌损伤指标、炎症指标及抗氧化指标比较,差异均无统计学意义(P>0.05);B组、C组术中5 min及术后即刻MAP均明显低于术前,HR均明显高于术前(P<0.05),A组变化不大(P>0.05);术中5 min及术后即刻,A组及C组的MAP均显著高于B组,A组均显著高于C组,HR均显著低于B组,A组均显著低于C组(P<0.05);术后24 h,B组、C组心肌损伤指标、MDA均明显高于术前,TAC、SOD均明显低于术前(P<0.05),A组变化不大(P>0.05);术后24 h,A组及C组的心肌损伤指标、炎症指标及MDA均显著低于B组,A组均显著低于C组,TAC及SOD均显著高于B组,A组均显著高于C组,差异均有统计学意义(P<0.05)。结论:内关穴注射地塞米松在骨科老年患者围手术期的心肌保护作用较好,对血流动力学的稳定效果较好。Objective:To investigate the perioperative application effect of Dexamethasone by injection of Neiguan acupoint in elderly patients with orthopedic surgery.Method:A total of 120 elderly patients with orthopedic surgery in Jinjiang Municipal Hospital from July 2023 to August 2024 were divided three groups with 40 cases in each group by the random number table.The group A was treated with Dexamethasone by injection of Neiguan acupoint,the group B was treated with normal saline by injection of Neiguan acupoint,the group C was treated with Dexamethasone by intravenous injection.Then the hemodynamics indexes[mean arterial pressure(MAP)and heart rate(HR)]before the operation,at 5 min during the operation and immediately after the operation,myocardial damage indexes[cardiac troponin I(cTnI),creatine kinase(CK),creatine kinase isoenzymes(CK-MB)and brain natriuretic peptide(BNP)],inflammation indexes[C reactive protein(CRP)and interleukin-6(IL-6)]and antioxidant indexes[total antioxidant capacity(TAC),superoxide dismutase(SOD)and malondialdehyde(MDA)]before the operation and at 24 h after the operation of three groups were compared.Result:There were no significant differences in hemodynamic indexes,myocardial injury indexes,inflammatory indexes,and antioxidant indexes among the three groups before operation(P>0.05).The MAP at 5 min during operation and immediately after operation in group B and group C were significantly lower than those before operation,and the HR was significantly higher than that before operation(P<0.05).There was no significant change in group A(P>0.05).5 min and immediately after operation,MAP of group A and group C were significantly higher than those group B,those of group A were significantly higher than those of group C,HR were significantly lower than those of group B,and those of group A were significantly lower than those of group C(P<0.05).At 24 h after operation,the myocardial injury index,MDA in group B and group C were significantly higher than those before operation,TAC and SOD were signi

关 键 词：内关穴 地塞米松 骨科手术 老年患者 围手术期 心肌保护 血流动力学 

分 类 号：R614[医药卫生—麻醉学]