内热针治疗椎间盘退行性疾病过程中动态心电监护的结果分析

Analysis of inner heating dry needle therapy in the treatment of degenerative disc disease with continuous dynamic ECG monitoring

目的通过监测内热针治疗（Inner heating dry needle therapy）椎间盘退行性疾病（degenerative disc disease,DDD）过程中不同时间点生命体征的变化,探讨内热针疗法的安全性。方法 2015年4月~2015年10月解放军总医院康复医学中心病区及门诊收治的椎间盘退行性疾病患者278例,进行内热针治疗,动态监测患者入室时、麻醉时、针刺时、治疗中及治疗后心率、呼吸、血压及血氧饱和度的变化。结果所有患者在心电监护下顺利完成治疗,术中无明显不适主诉,无心血管意外发生。心率、呼吸及血压在麻醉时和针刺时有升高趋势（P〈0.05）,一般持续10~20 min,但均在可控范围之内。麻醉时心率（77.13±11.78）次/min,呼吸（18.94±3.25）次/min,收缩压（130.8±17.06）mm Hg,舒张压（75.40±12.05）mm Hg;针刺时心率（76.67±11.85）次/min,呼吸（18.10±3.29）次/min,收缩压（128.97±16.84）mm Hg,舒张压（74.23±11.79）mm Hg。血氧饱和度在各个时间点差异无统计学意义。治疗后各指标恢复至入室前状态。结论在内热针治疗椎间盘退行性疾病过程中,心率、呼吸、血压在麻醉时和针刺时可出现一过性升高,但总体波动平稳可控,对生命体征影响较小,是一种安全性的治疗方法。治疗过程中应全程动态心电监护,尤其要密切关注麻醉和针刺时各生命体征的变化。

Objective To monitor the fluctuations of vital signs at different times during treatment of degenerative disc disease using with heating dry needle therapy. To analyze the safety of inner heating dry needle therapy. Methods Two hundred and seventy-eight patients with degenerative disc disease admitted to rehabilitation department of Chinese PLA General Hospital from April 2015 to October 2015 were enrolled and underwent inner heating dry needle therapy. Patients＇ heart rate,respiration,blood pressure and blood oxygen saturation were dynamically monitored upon entering therapy room,during anesthesia and acupuncture,during treatment and post treatment. Results All patients completed treatment successfully without obvious discomfort and cardiovascular accident. Heart rate,breathing and blood pressure tended to increase during anesthesia and acupuncture,but the increases only lasted 10 to 20 minutes and were controllable ：heart rate during anesthesia was（77.13 ± 11.78） bpm, breathing during anesthesia was（18.94 ± 3.25） bpm,systolic blood pressure during anesthesia was（128.97 ± 16.84） mm Hg,and diastolic blood pressure during anesthesia was（74.23 ± 11.79） mm Hg;heart rate during acupuncture was（76.67 ± 11.85） bpm, breathing during acupuncture was（18.10 ± 3.29） bpm,systolic blood pressure during acupuncture was（128.97 ± 16.84） mm Hg and diastolic blood pressure during acupuncture was（74.23 ± 11.79） mm Hg. No significant differences exist bewteen blood oxygen saturation levels measured at different times during treatment;after treatmental indicators returned to values before entering therapy room.Conclusion Despite a transient increase in vital signs during anesthesia and acupuncture,inner heating dry needle is proved to be a safe treatment of degenerative disc disease. Nevertheless, dynamic ECG monitoring will be used during therapy and it willbe pay attention to vital signs especially during acupuncture and anesthesia.