冥想训练、针灸联合全麻对鼻内镜术应激反应的影响

目的:探讨单纯全麻和呼吸冥想训练、针灸联合全麻对鼻内镜术应激反应的影响。方法:40例ASAⅠ～Ⅱ级择期鼻内镜术患者随机分为复合全麻组(GE组,20例)及单纯全麻组(G组,20例),分别于麻醉前(T0)、气管插管后(T1)、手术时(T2)、术毕气管拔管后(T3)静脉采血,测定去甲肾上腺素(NE)、皮质醇(COS)并记录同一时间点血压(BP)、心率(HR)。结果:两组T0时SBP、DBP、HR、NE、COS值比较差异无显著性(P>0.05);在T1时NE值GE组低于G组(P<0.05);T2时GE组SBP、DBP、NE和COS值低于G组(P<0.05或P<0.01);T3时DBP、SBP、NE和COS,GE组低于G组(P<0.05或P<0.01)。GE组T1、T2、T3时BP、NE、COS值较T0时明显降低(P<0.05或P<0.01),T3时GE组、G组各观察值恢复到术前水平。结论:全麻复合呼吸冥想训练、针灸抑制鼻内镜术应激反应效果优于单纯全麻,全麻复合呼吸冥想训练、针灸是鼻内镜术适宜的麻醉方法。

Objective：to study the general an- esthesia and breathing pure practice of meditation, acupuncture anesthesia nasal endoscopic operation of joint effects of stress reaction. Methods： Ⅰ -40 cases ASA intraoperative elective class Ⅱ nasal endoscopy patients were randomly divided into general anesthesia group（ GE group compound, n = 20 ） and pure general anesthesia group （ group G, n = 20）, respectively on anesthesia T0 ）, before （ after tracheal intubation T1 ）, surgery （ T2 ）, perioperative after Picasso extubated the trachea （ 33 ） venous blood sampling, determination of norepinephrine （ NE）, cortisol （COS） and record the same time point blood pressure （BP）,heart rate （ HR ）, the results ： two groups when TO DBP, HR, SBP, NE, COS value comparative differences no significant （ P 〉 0.05）. When GE on tl - weighted en value of less than group G （ P 〈 0.05 ）. T2 SBP, when DBP, GE group en is below group G and COS（P 〈0.05 or P 〈0.01 ） ;33 DBP, when SBP, NE and COS GE group below G group（P 〈 0.05 or P 〈0.01 ）. GE T1 ,T2 and 33 group when BP, NE TO, COS value when a significantly reduced（ P 〈 0.05 or P 〈 0.01 ）, T3 GE group, when the observation group G recovered to preoperative level. Conclusion： thirty - two composite breathing practice of meditation, acupuncture inhibit nasal endoscopic perioperative anesthesia stress reaction effect is better than pure compound breath meditation, general anesthesia nasal endoscopy training, acupuncture is intraoperative appropriate anes- thetic methods.