文章摘要
徐露露,杜鑫丹,赵文胜.经皮穴位电刺激在结核病患者肺部手术中的应用[J].浙江中医药大学学报,2020,44(12):1177-1182.
经皮穴位电刺激在结核病患者肺部手术中的应用
Application of Transcutaneous Electrical Acupoint Stimulation in Pulmonary Surgery of Tuberculosis Patients
投稿时间:2020-02-21  
DOI:10.16466/j.issn1005-5509.2020.12.007
中文关键词: 经皮穴位电刺激  肺结核  单肺通气  镇痛  血气分析  血流动力学  氧合功能
英文关键词: transcutaneous electrical acupoint stimulation(TEAS)  pulmonary tuberculosis  one-lung ventilation  analgesia  blood gas analysis  hemodynamics  oxygenation function
基金项目:国家重点基础研究发展计划(973计划)项目(2013CB531903);浙江省自然科学基金项目(LY14H270007);杭州市科学技术委员会资助项目(20170533B63)
作者单位E-mail
徐露露 浙江省中西医结合医院 杭州 310003  
杜鑫丹 浙江省中西医结合医院 杭州 310003  
赵文胜 浙江省中西医结合医院 杭州 310003 zjmzhaowensheng@163.com 
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中文摘要:
      [目的]分析经皮穴位电刺激(transcutaneous electrical acupoint stimulation,TEAS)在肺结核患者肺部手术中的镇痛作用及对单肺通气时肺氧合功能的影响。[方法]选择62例在全麻下行开胸脓胸清除术的肺结核患者,随机分为2组:T组(TEAS组),F组(假TEAS组)。两组取穴均为双侧后溪、支勾、内关、合谷,T组从麻醉诱导前30min开始用韩氏穴位神经电刺激仪刺激直至手术结束,F组仅将不干凝胶电极片贴于穴位并连接韩氏穴位神经电刺激仪,不给予电刺激。两组麻醉诱导及维持方法相同。分别于术前、术中及术后相应时间点记录血流动力学及呼吸力学指标,并抽取动脉血行血气分析,记录术中、术后舒芬太尼使用情况。[结果]两组患者一般情况比较差异无统计学意义(P>0.05),且两组患者各时点的平均动脉压(mean blood pressure,MAP)、呼吸生理学指标及血气分析指标差异均无统计学意义(P>0.05)。而与F组比较,T组单肺通气期间心率显著降低(P<0.05),各时段舒芬太尼使用量、患者自控静脉镇痛(patient controlled intravenous analgesia,PCIA)总按压次数、有效按压次数及视觉模拟评分法(visual analogue scale,VAS)评分均较低,差异有统计学意义(P<0.05)。[结论]TEAS能有效减少肺结核患者围术期麻醉镇痛药物的使用,有较好镇痛作用,但对患者肺氧合功能无显著影响。
英文摘要:
      [Objective] To analyze the analgesic effects of transcutaneous electrical acupoint stimulation(TEAS) in pulmonary surgery of tuberculosis patients and their effects on pulmonary oxygenation during one-lung ventilation. [Methods] Sixty-two patients with pulmonary tuberculosis who underwent general anesthesia for thoracotomy were randomly divided into two groups: Group T(TEAS group) and group F(Sham TEAS group).TEAS at bilateral Houxi, Zhigou, Neiguan and Hegu points was applied to the patients in group T 30min before induction of anesthesia to the end of operation. The same management was applied to patients in group F, with sham TEAS for control. The methods of induction and maintenance of anesthesia were the same in the two groups. The hemodynamic and respiratory mechanics were recorded before, during and after surgery, and the use of sufentanil in perioperative period was recorded. And arterial blood was extracted for blood gas analysis during the operation. [Results] There was no statistical difference in the general conditions of the two groups(P>0.05). And the mean blood pressure(MAP), respiratory physiology index and blood gas analysis index of group T at all phases were not significantly different from group F(P>0.05). While compared with group F, the heart rate of group T was significantly lower during one-lung ventilation(P<0.05),and the amount of sufentanil used in each period, the total number and effective number of patient controlled intravenous analgesia(PCIA) presses, as well as the visual analogue scale(VAS) scores were all lower in group T, and the differences were statistically significant(P<0.05).[Conclusion] TEAS can effectively reduce the use of narcotic analgesics in patients with pulmonary tuberculosis in perioperative period, has a good analgesic effect, but has no significant effect on patient's pulmonary oxygenation function.
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