电针预处理对经尿道前列腺电切术老年患者围术期寒战和应激反应的影响  

Effect of electroacupuncture preconditioning on perioperative shivering and stress responses in elderly patients undergoing transurethral resection of prostate

作　　者：齐倩颖 张彩举 周民涛 Qi Qianying;Zhang Caiju;Zhou Mintao(Department of Anesthesia and Perioperative Medicine,Nanyang First People′s Hospital Affiliated to Henan University,Nanyang 473010,China;Department of Anesthesiology,Heyou International Hospital,Foshan 528300,China)

机构地区：[1]河南大学附属南阳市第一人民医院麻醉与围术期医学科,南阳473010 [2]和祐国际医院麻醉科,佛山528300

出　　处：《中华麻醉学杂志》2025年第1期49-52,共4页Chinese Journal of Anesthesiology

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210973)。

摘　　要：目的评价电针预处理对经尿道前列腺电切术老年患者围术期寒战和应激反应的影响。方法本研究为随机对照试验。择期拟行经尿道前列腺电切术老年患者60例,年龄65~85岁,体质量60~85 kg,ASA分级Ⅱ或Ⅲ级。采用随机数字表法分为电针预处理组(E组)和对照组(C组),每组30例。2组患者均采用脊椎-硬膜外麻醉,E组在麻醉穿刺前30 min电针双侧内关穴和足三里穴,疏密波,频率2/100 Hz,电流强度3 mA,刺激时间30 min;C组不予电针处理。记录2组患者发生寒战和术后恶心呕吐、血管活性药物使用及镇痛补救情况;于电针前(T_(0))和术后2 h(T_(1))时抽取上肢外周静脉血,采用ELISA法测定血清IL-6、5-羟色胺(5-HT)、去甲肾上腺素(NE)和多巴胺(DA)的浓度。结果与T_(0)时比较,T_(1)时C组患者血清IL-6、5-HT、NE和DA浓度升高(P<0.05);与C组比较,E组患者寒战发生率、血管活性药物使用率和镇痛补救率降低,T_(1)时血清IL-6、5-HT、NE和DA浓度降低(P<0.05)。结论电针预处理可降低经尿道前列腺电切术老年患者围术期寒战发生,并抑制应激反应。ObjectiveTo evaluate the effect of electroacupuncture preconditioning on perioperative shivering and stress responses in elderly patients undergoing transurethral resection of the prostate.MethodsIn this randomized controlled trial,60 elderly patients,aged 65-85 yr,weighing 60-85 kg,of American Society of Anesthesiologists Physical Status classificationⅡorⅢ,scheduled for elective transurethral resection of the prostate,were divided into electroacupuncture preconditioning group(group E)and control group(group C)using the random number table method,with 30 patients in each group.Combined spinal-epidural anesthesia was used in two groups.Bilateral Neiguan and Zusanli acupoints were stimulated for 30 min,with disperse-dense waves,frequency 2/100 Hz,current intensity 3 mA,starting from 30 min before anesthesia puncture.Group C received no treatment.The incidence of shivering,postoperative nausea and vomiting,use of vasoactive drugs and rescue analgesia were recorded in the two groups.Peripheral venous blood samples from the upper limbs were collected before electroacupuncture treatment(T_(0))and at 2 h after operation(T_(1))for determination of serum concentrations of interleukin-6(IL-6),5-serotonin(5-HT),norepinephrine(NE)and dopamine(DA)by enzyme-linked immunosorbent assay.ResultsCompared with the baseline at T_(0),serum concentrations of IL-6,5-HT,NE and DA were significantly increased at T_(1)in group C(P<0.05).Compared with group C,the incidence of shivering,usage rate of vasoactive drugs and rate of rescue analgesia were significantly decreased,and the serum concentrations of IL-6,5-HT,NE and DA were decreased at T_(1)in group E(P<0.05).ConclusionsElectroacupuncture preconditioning can decrease the occurrence of perioperative shivering and inhibit stress responses in elderly patients undergoing transurethral resection of the prostate.

关 键 词：电针 经尿道前列腺切除术 老年人 围手术期 寒战 应激 

分 类 号：R246.2[医药卫生—针灸推拿学]