摘要
目的 评价电针对体外循环心脏瓣膜置换术患者术后转归的影响.方法 择期拟行体外循环心脏瓣膜置换术患者44例,性别不限,年龄18～55岁,体重指数18～25 kg/m^2,ASA分级Ⅲ级,NYHA分级Ⅱ或Ⅲ级,采用随机数字表法分为2组（n=22）：对照组（C组）和电针组（EA组）.EA组于诱导前20 min开始至术毕采用电针刺激双侧内关穴、郄门穴、神门穴和百会穴,频率为2 Hz的疏密波,电流1.0～ 1.2 mA.全麻诱导气管插管后行机械通气,采用静吸复合维持麻醉.于术前1d、术后1和3d时记录恢复质量（QoR-9）评分和MMSE评分.观察术后3d内恶心呕吐、术后认知功能障碍（POCD）、补救镇痛和室性心律失常的发生情况;记录术中舒芬太尼的用量、拔除气管导管时间、第1次肛门排气时间、第1次下床活动时间、ICU停留时间和术后住院时间.结果 与C组比较,EA组术中舒芬太尼用量减少,术后1和3d时QoR-9评分较高,术后3d内恶心呕吐、POCD和室性心律失常发生率降低,拔除气管导管时间、第1次肛门排气时间、第1次下床活动时间和术后住院时间缩短（P＜0.05）.结论 电针可促进体外循环心脏瓣膜置换术患者的术后转归.
Objective To evaluate the effect of electroacupuncture （EA） on postoperative outcome in the patients undergoing cardiac valve replacement with cardiopulmonary bypass （CPB）.Methods Forty-four patients of both sexes,aged 18-55 yr,with body mass index of 18-25 kg/m^2,of American Society of Anesthesiologists physical status Ⅲ,with New York Heart Association Ⅱ[or Ⅲ,scheduled for elective cardiac valve replacement with CPB,were divided into 2 groups （n =22 each） using a random number table：control group （group C） and group EA.In group EA,patients received EA stimulation with needles at bilateral Neiguan,Ximen,Shenmen and Baihui acupoints （disperse-dense waves,frequency 2 Hz,intensity 1.0-1.2 mA） from 20 min before anesthesia induction to the end of surgery.After induction of general anesthesia,the patients were endotracheally intubated and mechanically ventilated,and combined intravenous-inhalational anesthesia was used to maintain anesthesia.Quality of Recovery 9 and Minimum Mental State Examination scores were assessed on the day before surgery and 1 and 3 days after surgery.The development of nausea and vomiting,postoperative cognitive dysfunction,requirement for rescue analgesics and ventricular arrhythmia was recorded within 3 days after surgery.The consumption of sufentanil in surgery,extubation time,the first flatus time,the first postoperative off-bed time,duration of stay in the intensive care unit and length of hospital stay after sugery were recorded.Results Compared with group C,the consumption of sufentanil in surgery was significantly decreased,Quality of Recovery 9 scores were increased at 1 and 3 days after surgery,the incidence of nausea and vomiting,postoperative cognitive dysfunction and ventricular arrhythmia was decreased within 3 days after surgery,and the extubation time,the first flatus time,the first postoperative off-bed time and length of hospital stay after surgery were significantly shortened in group EA （P〈0.05）.Conclusion EA can promote postoperative outc
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2017年第1期50-53,共4页
Chinese Journal of Anesthesiology
关键词
电刺激疗法
心肺转流术
预后
Electric stimulation therapy
Cardiopulmonary bypass
Prognosis
