摘要
目的评价经皮穴位电刺激对全麻腹腔镜结直肠癌根治术患者术后肠粘膜损伤的影响。方法择期行腹腔镜结直肠癌根治术患者56例,性别不限,年龄35~64岁,体重指数18~25 kg/m2,ASA分级Ⅱ或Ⅲ级,采用随机数字表法分为2组(n=28):全身麻醉组(G组)和经皮穴位电刺激+全身麻醉组(TG组)。TG组于麻醉诱导前30 min时,经皮电刺激双侧内关、合谷、足三里及上、下巨虚穴持续至术毕,频率为2/100 Hz,疏密波,强度以患者能耐受的最大电流为宜(3~8 mA)。2组均采用静吸复合麻醉。分别于入室时(T1)、术毕即刻(T2)、术后24 h(T3)和术后72 h(T4)时,采集外周静脉血样,采用ELISA法测定血浆肠型脂肪酸结合蛋白(I-FABP)和二胺氧化酶(DAO)浓度;分别于术前24 h(T0)、T3和T4时采用QoR-9量表评估术后康复质量。结果与T1时比较,G组和TG组T2及T3时血浆I-FABP和DAO浓度升高(P<0.05);与T0时比较,G组和TG组T3和T4时QoR-9评分降低(P<0.05);与G组比较,TG组T2-T4时血浆I-FABP浓度及T2、T3时血浆DAO浓度降低,术后T3和T4时QoR-9评分升高(P<0.05)。结论经皮穴位电刺激可减轻全麻腹腔镜结直肠癌根治术患者术后肠粘膜损伤。
Objective To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on intestinal mucosal injury in patients undergoing laparoscopic radical resection of colorectal cancer. Methods Fifty-six American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients, aged 35-64 yr, with body mass index of 18-25 kg/m2, scheduled for elective laparoscopic radical resection of colorectal cancer, were selected and divided into 2 groups (n=28 each) using a random number table method: general anesthesia group (group G) and TEAS combined with general anesthesia group (group TG). In group TG, patients received continuous TEAS at bilateral Neiguan, Hegu, Zusanli, Shangjuxu and Xiajuxu acupoints from 30 min before anesthesia induction until the end of surgery, with a frequency 2/100 HZ, disperse dense waves, intensity the maximum current that could be tolerated (3-8 mA). After induction of anesthesia, the patients were endotracheally intubated and mechanically ventilated, and combined intravenous-inhalational anesthesia was used to maintain anesthesia in both groups.Peripheral venous blood samples were collected when entering the operating room (T1), at the end of operation (T2), and at 24 and 72 h after operation (T3, 4) for determination of intestinal fatty acid binding protein (I-FABP) and diamine oxidase (DAO) in palsma using enzyme-linked immunosorbent assay.Quality of Recovery-9 (QoR-9) was used to assess the postoperative quality of recovery at 24 h before surgery (T0), T3 and T4. Results The concentrations of plasma I-FABP and DAO were significantly higher at T2 and T3 than at T1 in G and TG groups (P<0.05). Compared with the baseline at T0, QoR-9 scores were significantly decreased at T3 and T4 in G and TG groups (P<0.05). Compared with group G, the concentrations of plasma I-FABP at T2 - T4 and DAO at T2 and T3 were significantly decreased, and QoR-9 scores were increased at T3 and T4 in group TG (P<0.05). Conclusion TEAS can attenuate intestinal mucosal injury in patients undergoing laparosco
作者
范学明
章放香
黄玲
陈冰凝
张伟晶
张竞超
Fan Xueming;Zhang Fangxiang;Huang Ling;Chen Bingning;Zhang Weijing;Zhang Jingchao(Department of Anesthesiology, People′s Hospital of Guizhou Medical University, 550002 Guiyang, China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2019年第1期52-55,共4页
Chinese Journal of Anesthesiology
基金
贵州省人民医院国家自然科学基金培育基金(黔科合平台人才[2018]5764-07).
关键词
电刺激疗法
麻醉
全身
腹腔镜检查
肠黏膜
Electric stimulation therapy
Anesthesia, general
Laparoscopy
Intestinal mucosa
