摘要
目的探讨电针预处理对胃癌根治术患者应激状态及术后谵妄的影响。方法将80例行胃癌根治术的患者依据术前处理方式不同分为电针组(42例)和常规组(38例),常规组予以常规麻醉,电针组在常规麻醉前予以电针预处理,比较两组患者手术相关指标、应激状态、麻醉药物用量及术后并发症发生情况。结果两组患者手术时间、术中出血量、术中输液量、拔管时间、苏醒时间比较,差异均无统计学意义(P﹥0.05)。预处理前,两组患者心率、血氧饱和度及平均动脉压比较,差异均无统计学意义(P﹥0.05);开腹时及手术结束后,电针组患者心率均低于常规组,血氧饱和度、平均动脉压均高于常规组,差异均有统计学意义(P﹤0.05)。治疗前,两组患者CD4^(+)、CD4^(+)/CD8^(+)及超敏C反应蛋白(hs-CRP)水平比较,差异均无统计学意义(P﹥0.05);治疗后,两组患者CD4^(+)与CD4^(+)/CD8^(+)均降低,hs-CRP均升高(P﹤0.05),且电针组患者CD4^(+)与CD4^(+)/CD8^(+)均明显高于常规组,hs-CRP明显低于常规组(P﹤0.01)。电针组患者瑞芬太尼用量少于常规组,视觉模拟评分(VAS)低于常规组,谵妄发生率低于常规组,差异均有统计学意义(P﹤0.05)。结论电针预处理能够减少全身麻醉药物瑞芬太尼用量,降低机体应激反应,减少术后谵妄的发生。
Objective To investigate the effect of electroacupuncture preconditioning on stress state and postopera-tive delirium in patients undergoing radical resection of gastric cancer.Method A total of 80 patients undergoing radical resection of gastric cancer were divided into electroacupuncture group(n=42,pretreated with electroacupuncture before conventional anesthesia)and routine group(n=38,treated with conventional anesthesia);the operation-related indexes,stress state,anesthetic dosage and postoperative complications were compared between the two groups.Result There was no significant difference in operation time,intraoperative blood loss,intraoperative infusion volume,extubation time and recovery time between the two groups(P>0.05);there were no significant differences for the heart rate,blood oxygen saturation and mean arterial pressure between the two groups before preconditioning(P>0.05);during laparotomy and af-ter operation,the heart rate in the electroacupuncture group was significantly lower,blood oxygen saturation and mean ar-terial pressure higher than those in the routine group(P<0.05);before treatment,there were no significant differences for the CD4^(+),CD4^(+)/CD8^(+)and high-sensitivity C-reactive protein(hs-CRP)(P>0.05);after treatment,the CD4^(+)and CD4^(+)/CD8^(+)decreased and hs-CRP increased in both groups(P<0.05),with higher CD4^(+),CD4^(+)/CD8^(+)and lower hs-CRP in the electroacupuncture group than those in the routine group(P<0.05);the amount of remifentanil in electroacupuncture group was less than that in conventional group,the visual analog scale(VAS)score was lower than that in conventional group,and the incidence of delirium was lower than that in conventional group,with statistical significance(P<0.05).Conclusion The electroacupuncture preconditioning can reduce the dosage of remifentanil,reduce the stress reaction and reduce the occurrence of postoperative delirium.
作者
万义芹
曹维福
周瑛昊
WAN Yiqin;CAO Weifu;ZHOU Yinghao(Department of Anesthesiology,Nanyang First People’s Hospital,Nanyang 473000,He’nan,China)
出处
《癌症进展》
2021年第24期2559-2562,共4页
Oncology Progress
关键词
电针
预处理
胃癌
根治术
谵妄
electroacupuncture
preconditioning
gastric cancer
radical operation
delirium
