中医耳穴埋籽对肠癌Miles术患者血流动力学及应激反应中激素水平的影响研究

Study for the effect on stress hormone level and hemo-dynamics among rectal cancer Miles patients treated by auricular seeds of traditional Chinese medicine

目的探讨耳穴埋籽对直肠癌Miles手术患者血流动力学及应激水平变化的影响研究。方法将92例直肠癌行Miles手术患者按照入院先后顺序随机分为观察组47例和对照组45例。对照组行常规围手术期护理,观察组在常规围手术期护理的同时给予耳穴埋籽,术后心电监护48h,24h内每小时监测收缩压(SBP)、舒张压(DBP)、心率(HR)、呼吸频率(RR)、脉搏氧饱和度(SpO2),24h后至48h每2h监测;在患者入院时、术后1d、术后2d监测血清皮质醇浓度。结果两组患者的收缩压、舒张压在12h、18h、24h、36h、48h比较差异有统计学意义(P<0.05),HR、RR、SpO2比较差异无统计学意义(P>0.05),说明各组的HR、RR、SpO2在各时间点虽有变化,但无显著影响;两组患者术前皮质醇浓度无明显差异,术后均明显升高,至术后第2天,观察组皮质醇浓度降至术前水平,对照组仍高于术前水平(P<0.05)。结论耳穴埋籽在围手术期可以有效地稳定患者的SBP、DBP;能够显著降低血清皮质醇的浓度,减轻机体应激反应。

Objective To study the effect on stress hormone level and hemo‐dynamics among colon cancer Miles patients treated by auricular seeds of traditional Chinese medicine .Method 92 patients with rectal cancer underwent Miles operation based on the order of admission were randomly divided into intervention group 47 cases and 45 cases of group control .The control group received routine nursing during operation period .The intervention groups re‐ceived auricular seeds in conventional operation period at the same time .Postoperative ECG monitoring was conduc‐ted for 48 h .The systolic and diastolic blood pressure ,heart rate ,respiratory rate ,pulse oxygen saturation was monitored each hours with 24 hours ,and monitored every 2 h after 24 h to 48 h .The serum cortisol concentration was monitored at the admission day ,1 days and two days after operation .Result The systolic blood pressure ,dias‐tolic blood pressure at 12 h ,18 h 24 h ,36 h and 48 h was significantly different between the two groups （P0 .05） ,HR ,RR and SpO2 was changed in all groups at each monitor period .There was no significant difference between groups .The cortisol concentration was no significant difference between group before operation .Post‐operation cortisol were significant‐ly increased after second days ,and the intervention group decreased to preoperative levels .The cortisol concentration was higher than that of the preoperative level in control group （P〈0 .05） .Conclusion Auricular seeds of TCM nurs‐ing during operation period can be effect for the stable of patients SBP and DBP ,and reduce remarkable the patients＇serum concentration of cortisol and patients＇stress reaction .