摘要
目的:观察穴位电刺激结合腰硬联合麻醉对老年骨科下肢手术患者体温变化、简明精神状态量表(MMSE)评分及苏醒时间的影响。方法:将在本院接受骨科下肢手术的老年患者64例随机分为2组,对照组32例予以腰硬联合麻醉,研究组32例在对照组的基础上予以中医穴位电刺激。监测2组体温变化情况,比较2组MMSE评分以及苏醒时间、手术时间、术中出血量,记录2组血液流变学指标变化情况。结果:2组切皮后30 min体温均明显低于干预前(P<0.05),2组切皮后90 min体温均明显低于干预前、切皮后30 min(P<0.05);研究组切皮后30 min、90 min体温均明显高于对照组(P<0.05)。干预后,研究组MMSE评分明显高于对照组(P<0.05),而与同组干预前比较,差异无统计学意义(P>0.05);干预后,对照组MMSE评分明显低于干预前(P<0.05)。研究组苏醒时间、手术时间、术中出血量均明显小于对照组(P<0.05)。干预后,对照组除血浆黏度之外,患者全血高切黏度、全血低切黏度、血浆黏度、红细胞压积、血小板黏附率等指标均较干预前明显改善(P<0.05);干预后,研究组上述各项血液流变学指标均较干预前明显改善(P<0.05),且改善明显优于对照组(P<0.05)。结论:中医穴位电刺激结合腰硬联合麻醉,可有效控制老年骨科下肢手术患者体温下降速度,减少患者苏醒时间、手术时间及术中出血量,改善患者精神状态及血液流变学状态。
Objective:To observe the effect of electric point stimulation in Chinese medicine and combined spinalepidural anesthesia on the temperature,score of Mini-Mental State Examination(MMSE)and awakening time in elderly patients undergoing lower extremity surgery in orthopedics department.Methods:A total of 64 elderly patients undergoing lower limb surgery in our hospital were randomly divided into two groups,32 cases in each group.The control group was given combined spinal-epidural anesthesia,and the study group was additionally given electric point stimulation based on the treatment of the control group.Changes of temperature in the two groups were monitored;the MMSE scores,awakening time,operation time and intra-operative blood loss were compared,and the changes of hemorheological indexes in the two groups were recorded.Results:Thirty minutes after skin incision,the temperature in both groups was significantly lower than that before the intervention respectively(P<0.05).Ninety minutes after skin incision,the temperature in both groups was significantly lower than that before the intervention and thirty minutes after skin incision(P<0.05).The temperature in the study group thirty minutes and ninety minutes after skin incision was higher than that in the control group respectively(P<0.05).After the intervention,the MMSE score in the study group was significantly higher than that in the control group(P<0.05).The awakening time,operation time and intraoperative blood loss in the study group were significantly less than those in the control group(P<0.05).After the intervention,in addition to plasma viscosity in the control group,indexes such as high whole blood viscosity,low whole blood viscosity,plasma viscosity,hematocrit,platelet adhesion rate in patients were significantly improved when compared with those before intervention(P<0.05),and the improvement in the study group was significant(P<0.05),and was better than that in the control group(P<0.05).Conclusion:Electric point stimulation in Chinese medicine and combined spinal-epidural anesthesia,can effectively control the rate of reduction of temperature in elderly patients undergoing lower extremity surgery,reduce the awakening time,operation time and intraoperative blood loss,and improve their mental state and hemorheological indexes.
出处
《新中医》
CAS
2020年第23期98-101,共4页
New Chinese Medicine
关键词
骨科下肢手术
中医穴位电刺激
腰硬联合麻醉
体温变化
简明精神状态量表评分
苏醒时间
Orthopedic lower extremity surgery
Electric point stimulation in Chinese medicine
Combined spinal-epidural anesthesia
Temperature changes
Mini-Mental State Examination
Awakening time
