摘要
目的研究电针预处理对甲状腺术后血流动力学和术后镇痛的影响。方法选取南阳市第一人民医疗择期行甲状腺手术60例,按数字表法随机分为观察组和对照组,每组30例,两组患者均采用气管插管全身麻醉,观察组患者术前电针刺激合谷穴30 min;对照组术后采用舒芬太尼静脉自控镇痛。记录两组患者电针刺激前(T0)、术后2 h(T1)、术后12 h(T2)、术后24 h(T3)和术后48 h(T4)各时间点的视觉模拟评分(VAS)、平均动脉压和心率,并抽血测量各时间点两组患者的促肾上腺皮质激素(ACTH)和C-反应蛋白(CRP)神经内分泌激素水平。结果(1)两组患者术后血流动力学变化比较:组内比较,对照组平均动脉压和心率在T1、T2和T3与T0比较,显著升高(P<0.05),差异有统计学意义;组间比较,对照组平均动脉压和心率在T1、T2和T3时间点与观察组比较,显著升高(P<0.05),差异有统计学意义。(2)两组患者VAS评分比较:组内比较,对照组VAS评分在T1、T2和T3时间点与T0比较,显著升高(P<0.05),差异有统计学意义;组间比较,对照组VAS评分在T1、T2和T3时间点与观察组比较,显著升高(P<0.05),差异有统计学意义。(3)两组患者ACTH和CRP含量比较:组内比较,对照组ACTH和CRP含量在T1、T2和T3时间点与T0比较,均显著升高(P<0.05),差异有统计学意义;组间比较,对照组ACTH和CRP含量在T1、T2和T3时间点与观察组比较,显著升高(P<0.05),差异有统计学意义。结论甲状腺患者麻醉诱导前电针刺激预处理,术中血流动力学更平稳,并能为患者提供术后满意的镇痛,其机制可能与电针刺激抑制ACTH和CRP的释放有关。
Objective To study the effect ofelectroacupuncture preconditioning on hemodynamics and postoperative analgesia after thyroidectomy.Methods Sixty patients undergoing elective thyroid surgery in Nanyang were randomly divided into observation group and control group according to the digital table method,30 cases in each group.All patients underwent general anesthesia with tracheal intubation.The patients in the observation group were stimulated by electroacupuncture at Hegu(LI4)for 30 minutes.In the control group,sufentanil was used for intravenous analgesia.The visual analogue scale(VAS)of the two groups was recorded before(T0),2 h(T1),12 h(T2),24 h(T3)and 48 h(T4)after surgery.Mean arterial pressure and heart rate were measured,and blood samples were taken out to measure the levels of adrenocorticotropic hormone(ACTH)and C-reactive protein(CRP)neuroendocrine hormones in the two groups at each time point.Results(1)Hemodynamics comparison between the two groups:The mean arterial pressure and heart rate of the control group were significantly higher than those at T0,T1,T2 and T3(P<0.05),and the difference was statistically significant.The mean arterial pressure and heart rate in the control group were significantly higher than those in the observation group at the T1,T2 and T3(P<0.05),and the difference was statistically significant.(2)Comparison of VAS scores between the two groups:The VAS scores of the control group were significantly higher than those at T0,T1,T2 and T3(P<0.05),and the difference was statistically significant.The VAS scores of the control group were significantly higher than those of the observation group at T1,T2 and T3(P<0.05),and the difference was statistically significant.(3)Comparison of ACTH and CRP levels in the two groups:The levels of ACTH and CRP in the control group were significantly higher than those at T0,T1,T2 and T3(P<0.05),and the difference was statistically significant.The levels of ACTH and CRP in the control group were significantly higher than those in the observation group
作者
张彩举
周民涛
付金厚
李熳
ZHANG Caiju;ZHOU Mintao;FU Jinhou;LI Man(The First People's Hospital in Nanyang,The Affiliated Hospital of Henan University,Nanyang 473000,Henan,China;Department of Neurobiology,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China)
出处
《辽宁中医杂志》
CAS
2020年第1期147-149,共3页
Liaoning Journal of Traditional Chinese Medicine
基金
国家自然科学基金(81473768).
关键词
电针
预处理
甲状腺手术
血流动力学
术后镇痛
electroacupuncture
preconditioning
thyroid surgery
hemodynamics
postoperative analgesia
