电针足三里、肺俞对肺癌根治术老年患者术后炎性反应及肺部并发症的影响

Impacts of electroacupucnture at Zusanli(ST 36) and Feishu(BL 13) on the postoperative inflammatory reaction and pulmonary complications in senile patients after radical resection of pulmonary carcinoma

目的:观察术前30min至手术结束电针足三里、肺俞对肺癌根治术老年患者术后炎性反应及肺部并发症的影响。方法:选择老年肺癌手术患者80例随机分为观察组和对照组,每组40例。观察组于术前30min电针刺激双侧足三里、肺俞直至手术结束,对照组不做任何电刺激。分别于术前(T_1,基础状态)、术后12h(T_2)和24h(T_3)时经中心静脉采集血样,检测血浆肿瘤坏死因子-ɑ(TNF-ɑ)和白细胞介素-10(IL-10)浓度,并于上述时点采集桡动脉血样,测定氧分压(PaO_2),计算肺泡-动脉氧分压差(P_(A-a)DO_2))及氧合指数(OI),记录术后2d内肺部并发症的发生情况。结果:与对照组比较,观察组T2、T3时血浆TNF-ɑ浓度、P_(A-a)DO_2较低(均P<0.05),血浆IL-10浓度及OI较高(均P<0.05);观察组术后肺炎、急性肺损伤的发生率较对照组低(均P<0.05)。结论:电针可降低肺癌根治术老年患者术后炎性反应,从而减少术后肺部并发症发生。

Objective To observe the impacts of electroacupuncture （EA） at Zusanli （ST 36） and Feishu （BL 13） applied 30 rain before the operation till the end of the operation on the postoperative inflammatory reaction and pulmonary complications in the senile patients after radical resection of pulmonary carcinoma. Methods Eighty senile patients of pulmonary carcinoma were selected and randomized into an observation group and a control group, 40 cases in each one. In the observation group, EA stimulation at Zusanli （ST 36） and Feishu （BL 13） was used 30 rain before the operation till the end of the operation. In the control group, electric stimulation was not used. Separately, before operation （T1, basic state）, 12 h after operation （T2） and 24 h after operation （T3）, blood sample was collected from the central vein. The concentrations of plasma tumor necrosis factor-α （TNF-α） and interleukin-10 （IL-10） were detected. Additionally, the radial arterial blood sample was collected at the above time points; oxygen partial pressure （PaO2） was determined; pulmonary alveoli-arterial partial pressure of oxygen （PA-aDO2） and oxygenation index （OI） were calculated. The pulmonary complication in the two days after opera- tion vcas recorded. Results Compared with the control group, in the observation group, at T2 and T3, TNF-a concentration and PA-,DOz were lower （all P〈0.05）; plasma IL-10 concentration and OI were higher （all P〈 0.05）. In the observation group, the incidences of postoperative pneumonia and acute pulmonary injury were lower than those in the control group （both P〈0.05）. Conclusion EA reduces the postoperative inflammatory reaction in the senile patients with radical resection of pulmonary carcinoma and decreases the postoperative pulmonary complications.