“智三针”电针疗法对老年全膝关节置换术后谵妄的影响

Effect of Mental Tri-needle Electro-acupuncture on Postoperative Delirium in Elderly Patients After Total Knee Arthroplasty

目的探讨"智三针"电针疗法对老年全膝关节置换术后谵妄的影响。方法择期行单侧全膝关节置换术老年患者96例,按入院时间先后采用随机数字表法均分为电针治疗组(A组)和对照组(B组),每组48例。A组:术前第1天及术后第1、2、3 d行"智三针"电针刺激疗法,余治疗参考B组;B组:术后加强生命体征监护及护理、改善营养、补液维持机体内稳态、预防感染及DVT、早期患肢功能锻炼等术后临床常规治疗。采用记忆谵妄评定量表(MDAS)对两组患者术毕第1、2、3、5 d进行评分,并通过CAM诊断标准统计术毕第1、2、3、5 d两组谵妄患者发生率。结果经MDAS量表评估发现术毕第1、2、3、5 d A组评分均低于B组(P<0.05);谵妄发生率在术后第1、2、3、5 d,B组均高于A组,差异有统计学意义(P<0.05)。结论"智三针"电针疗法能有效降低老年全膝关节置换术后谵妄的发生。

Objective To investigate the effect of mental tri-needle electro-acupuncture（EA） on the postoperative delirium（POD） in the elderly patients after total knee arthroplasty. Methods A total of 96 elderly patients were selected whole total knee arthroplasty were enrolled into the study. The patients were divided into EA treatment group（A group） and control group（B group） according to admission time and by random number table, 48 cases in each group. After surgery two groups of patients were given signs monitoring and care,improve nutrition, rehydration, maintaining the body＇s homeostasis, prevention of infection and DVT, early limb function exercises, such as routine clinical treatment. The first and the second and the third day before operation, the treatment group were given mental tri-needle.On postoperative day 1,2,3,5,we record the scores by the Memnrial Delirium Assessment Scale（MADS）,and calculated the incidence of POD by Confusion Assessment Method（CAM）.Results（1）On postoperative day 1,2,3,5,the treatment group had lower MDAS scores than the control group（P〈0.05）.（2）The incidence of delirium in B group was higher than that of group A at first, second, third and 5 days after operation, the difference was statistically significant（P〈0.05）.Conclusion Mental tri-needle electro-acupuncture is effective on decreasing the POD incidence of the elderly patients after total knee arthroplasty.