摘要
目的探讨不同时点电针刺激对结直肠癌手术患者术后炎性反应及内环境的影响。方法选择宁夏医科大学总医院择期行开腹结直肠癌根治性手术的患者80例,年龄18~59岁,ASA分级Ⅰ~Ⅲ级。随机分为4组,全凭静脉麻醉组(C组)、电针刺激EA1组、EA2组、EA3组,每组20例。给予相同的麻醉方法及镇痛处理。EA1组术前1天,EA2组术前1天、术前30min,EA3组术前1天、术前30min、术后1天行电针刺激治疗。术前穴位取中脘及右侧天枢、内关、足三里、上巨虚、下巨虚,术后1d穴位取右侧内关、足三里、上巨虚、下巨虚,穴位电针刺激治疗持续30min。记录患者术前(T1)、术后1天(T4)、术后5天(T5)静脉血白细胞、中性粒细胞计数;术前(T1)、术中冲洗后(T2),术后1天(T4)动脉血乳酸值;术前(T1)、术毕(T3)、术后1天(T4)、术后5天(T5)静脉血钾离子(K+)、钠离子(Na+)、氯离子(Cl-)。结果四组患者白细胞及中性粒细胞计数在T1时间点差异无统计学意义(P>0.05)。与C组比较,T4时EA1、EA3组白细胞、中性粒细胞计数减少(P<0.05),EA2组差异无统计学意义(P>0.05)。与EA1组比较,EA2、EA3组白细胞、中性粒细胞计数差异无统计学意义(P>0.05)。与EA2组比较,EA3组白细胞、中性粒细胞计数无统计学意义(P>0.05)。组内比较:与T1比较,T4时点4组白细胞、中性粒细胞计数升高(P<0.01),在T5时点EA1组白细胞、中性粒细胞及EA3组中性粒细胞计数升高(P<0.01)。与T4比较,4组白细胞及中性粒细胞在T5时点降低(P<0.01)。四组不同时间点血乳酸值组间比较差异无统计学意义(P>0.05)。组内比较:与T1比较,四组乳酸值在T2增高(P<0.01),在T4四组乳酸值趋近于T1水平,差异无统计学意义(P>0.05);与T2比较,T4时点EA2组乳酸值降低(P<0.05),C、EA1、EA3组乳酸值降低(P<0.05或<0.01)。四组患者不同时点电解质浓度组内比较、组间比较差异均无统计学意义(P均>0.05)。结论电针刺激�
Objective To investigate the efficacy of electroacupuncture（EA） at different time points on inflammatory response and internal environment in patients with colorectal cancer surgery. Methods A prospective study was performed on 80 patients,18-59 years of age,diagnosed with colorectal cancer undergoing laparotomy from April 2017. According to Ⅰ-Ⅲ grade of American Society of Anesthesiology（ASA）,the patients were randomly divided into 4 groups. Group C： 20 patients were given total intravenous anesthesia and gastrointestinal decompression. Group EA1： 20 patients were given total intravenous anesthesia,gastrointestinal decompression combined with EA stimulation 24 hours before surgery. Group EA2： 20 patients were given total intravenous anesthesia,gastrointestinal decompression combined with EA stimulation 24 hours and 30 minutes before surgery. Group EA3： 20 patients were given total intravenous anesthesia,gastrointestinal decompression combined with EA stimulation 24 hours and 30 minuites before surgery and 24 hours after surgery. Groups EA1,EA2,and EA3 received EA pretreatment at right acupoints Zhongwan（CV 12）,Tianshu（ST 25）,Zusanli（ST 36）,Neiguan（PC 6）,Shangjuxu（ST 37）,Xiajuxu（ST 39）. In addition,because of surgical incision,group EA3 received EA posttreatment at right acupoints Neiguan（PC 6）,Zusanli（ST 36）,Shangjuxu（ST 37）and Xiajuxu（ST 39）24 hours postoperatively. All EA treatments lasted 0.5 hours.Venous blood was collected to record white blood cell（WBC）count and neutrophil（NEUT）count before surgery（T1）,1 days after surgery（T4）,and 5 days after surgery（T5）. Arterial blood was collected to record lactate levels before surgery（T1）,after Intraoperative irrigation（T2）,and 1 days after surgery（T4）,and to record potassium（K＋）,sodium ion（Na＋）,chloride（Cl-）before operation（T1）,after operation（T3）,1 days after operation（T4）,5 days after operation（T5）. Results The WBC and NEUT count in the four
作者
马金孝
王天渊
孟尽海
麦思聪
MA Jinxiao;WANG Tianyuan;MENG Jinhai;MAI Sicong(Department of Anesthesiology,People＇s Hospital of Ningxia Hui Autonomous Region（First Affiliated Hospital of Northwest University for Nationalities）,Yinchuan 750021;Ningxia Medical University,Yinchuan 750004;Department of Anesthesiology,the General Hospital of Ningxia Medical University,Yinchuan 750004)
出处
《宁夏医科大学学报》
2018年第2期165-169,共5页
Journal of Ningxia Medical University
基金
宁夏卫计委医疗卫生科研计划项目(2011003)
关键词
结直肠癌开腹手术
电针
预处理
炎性反应
内环境
colorectal cancer laparotomy
electroacupuncture
pretreatment
inflammatory response
internal environment
