经皮穴位电刺激联合瑞芬太尼对鼻内镜手术患者应激反应的影响  

Effect of Transcutaneous Acupoint Electrical Stimulation Combined with Remifentanil on Stress Response in Patients Undergoing Nasal Endoscopic Surgery

作　　者：麦展辉 钟慧明 梁炎玲 MAI Zhanhui;ZHONG Huiming;LIANG Yanling(Department of Anaesthesiology,Panyu Hospital of Traditional Chinese Medicine,Guangzhou 511400,Guangdong,China)

机构地区：[1]广州番禺区中医院麻醉科,广东广州511400

出　　处：《世界复合医学(中英文)》2024年第10期128-131,共4页World Journal of Complex Medicine

基　　金：番禺区科技计划项目(2022-Z04-038)。

摘　　要：目的 探究经皮穴位电刺激、瑞芬太尼联合应用在鼻内镜手术中对患者临床应激反应的影响。方法 回顾性选取2022年10月—2023年9月广州番禺区中医院收治的100例鼻内镜手术患者的临床资料,根据不同的麻醉用药分为两组,各50例。对照组接受单纯瑞芬太尼复合麻醉,研究组接受经皮穴位电刺激联合瑞芬太尼复合麻醉。比较两组气管插管前(T_(1))、气管插管时(T_(2))、手术开始10 min后(T_(3))、手术结束时(T_(4))的应激反应水平(β-内啡肽、去甲肾上腺素)、血流动力学指标(心率及平均动脉压)。结果 麻醉后,研究组T_(2)、T_(3)的β-内啡肽及去甲肾上腺素水平均低于对照组,差异有统计学意义(P均<0.05)。研究组T_(2)、T_(3)的心率分别为(99.79±8.01)次/min、(89.42±7.71)次/min,平均动脉压分别为(96.15±7.09)mmHg、(90.96±6.00)mmHg,均低于对照组的(109.66±8.55)次/min、(98.99±7.65)次/min、(109.49±7.77)mmHg、(102.55±6.28)mmHg,差异有统计学意义(t=5.957、6.230、8.968、9.436,P均<0.05)。结论 经皮穴位电刺激联合瑞芬太尼可改善鼻内镜手术患者术后的应激反应水平、维持术中血流动力学稳定性。Objective To explore the effect of transcutaneous acupoint electrical stimulation combined with remifentanil on clinical stress response in patients undergoing nasal endoscopic surgery.Methods The clinical data of 100 patients with nasal endoscopic surgery admitted to Panyu Hospital of traditional Chinese Medicine from October 2022 to September 2023 were retrospectively selected.According to different anesthetic drugs,they were divided into two groups,50 cases in each group.The control group received simple remifentanil combined anesthesia,and the study group received transcutaneous electrical acupoint stimulation combined with remifentanil combined anesthesia.The stress response levels (β-endorphin,norepinephrine),hemodynamic indexes (heart rate and mean arterial pressure) were compared between the two groups before tracheal intubation (T_1),during tracheal intubation (T_2),10 min after the beginning of surgery (T_3) and at the end of surgery(T_4).Results After anesthesia,the β-endorphin and norepinephrine levels of T_(2) and T_(3) in the study group were lower than those in the control group,and the differences were statistically significant (both P<0.05).The heart rate of T_(2) and T_(3) in the study group were (99.79±8.01) times/min and (89.42±7.71) times/min,respectively,and the mean arterial pressure were (96.15±7.09) mmHg and (90.96±6.00) mmHg,respectively,which were lower than (109.66±8.55) times/min,(98.99±7.65) times/min,(109.49±7.77) mmHg,(102.55±6.28) mmHg in the control group,the differences were statistically significant (t=5.957,6.230,8.968,9.436,all P<0.05).Conclusion Transcutaneous acupoint electrical stimulation combined with remifentanil combined anesthesia can improve the postoperative stress response level and maintain the hemodynamic stability in patients undergoing endoscopic sinus surgery.

关 键 词：经皮穴位电刺激 瑞芬太尼 鼻内镜手术 应激反应 

分 类 号：R614[医药卫生—麻醉学]