针刺联合异丙酚防治胃镜检查术中应激反应的研究

Application of Acupuncture Combined with Propofol on Preventing the Stress Response in Gastroscopy

目的观察针刺联合异丙酚复合麻醉防治胃镜检查中应激反应的效果。方法将135例胃镜检查患者随机分为实验组、对照1组和对照2组,每组45例。实验组采用针刺合谷、内关、足三里穴与异丙酚静脉麻醉相结合;对照1组采用芬太尼与异丙酚静脉麻醉相结合;对照2组单纯异丙酚静脉麻醉。检测3组患者在胃镜检查过程中血压(BP)、心率(HR)、呼吸频率(RR)和血氧饱和度(SPO2)等指标的变化,记录患者异丙酚用量、胃镜操作时间、患者苏醒时间,观察患者胃镜检查应激反应并比较防治效果。结果实验组患者检查中BP、HR、RR和SPO2的变化较对照1组、对照2组稳定(P<0.05或P<0.01)。实验组异丙酚用量、胃镜操作时间、患者苏醒时间均少于对照2组,对应激反应的防治效果亦优于对照2组(P<0.01或P<0.05);但与对照1组比较,实验组上述指标差异无统计学意义(P>0.05)。结论针刺联合异丙酚麻醉是防治胃镜检查应激反应有效方法之一,具有对患者呼吸、循环影响较小,保持患者生理机能相对稳定的优势。

Objective To study the effect of acupuncture combined with Propofol in anesthesia on preventing the stress reaction in gastroscopy.Methods Totally 135 cases underwent gastroscopy were randomized into an experiment group and two control groups with 45 cases in each. The experiment group was treated by acupuncture at Hegu （LI 4）,Neiguan （PC 6）,and Zusanli （ST 36） in combined with venous administration of Propofol for anesthesia; while the control group Ⅰ was applied venous administration of Propofol combined with Fentanyl Citrate,and the control group Ⅱ was given venous administration of Propofol only. The changes of blood pressure （BP）,heart rate （HR）,respiration rate （RR）,and oxyhemoglobin saturation （SPO2） were investigated in all three groups. The amount of Propofol used,lasting time of gastroscopy,and awaking time of patient were recorded. The stress reaction was observed to compare the effect of prevention.Results In the experiment group,BP,HR,RR,and SPO2 were more stable than those in the control groups （P〈0.05 or P〈0.01）. The amount of Propofol used,lasting time of gastroscopy,and awaking time of patient of the experimental group were decreased as compared with those in the control group Ⅱ,and the effect on preventing the stress response was better than that of the control group Ⅱ （P〈0.05 or P〈0.01）,but there was no statistical significance in the above-mentioned indices as compared with the control group Ⅰ （P〉0.05）.Conclusion Acupuncture combined with Propofol for anesthesia is an effective method of preventing the stress response in gastroscopy,having the advantage of less impact on respiration and circulation systems of patient,beneficial to the stable physiological condition of patient.