“智三针”电针刺激对老年髋关节置换术后认知功能的影响

Effect of Mental Tri-needle Electro-acupuncture on Postoperative Cognitive Function in Elderly Patients After Hip Joint Replacement Surgery

【目的】探讨"智三针"电针刺激对老年髋关节置换术后认知功能的影响。【方法】纳入择期行全髋关节置换术老年患者120例,按手术时间随机分为电针治疗组(治疗组)和对照组,每组60例。对照组给予术后临床常规治疗,治疗组在对照组术后临床常规治疗的基础上,于术毕前30 min及术后第1、2天行"智三针"电针刺激疗法。记录2组麻醉停止后自主呼吸恢复时间、唤之睁眼时间、意识完全恢复时间、拔管时间及苏醒评分(Steward评分)情况;采用认知功能恢复质量量表(PQRS)评估2组患者术后第1、2、3、5、7天的认知功能评分,并统计术毕第1、2、3、5、7天认知功能障碍(POCD)发生率。【结果】(1)治疗组唤之睁眼时间、意识完全恢复时间、拔管时间均较对照组缩短(P<0.01),苏醒评分(Steward评分)也显著高于对照组(P<0.01)。(2)术毕第1、2、3、5、7天,治疗组术后PQRS量表评分均明显高于对照组(P<0.01)。(3)术后第1、2、3、5、7天,治疗组的POCD发生率均低于对照组,除术后第7天外,其余各时间点差异均有统计学意义(P<0.05)。【结论】"智三针"电针刺激能改善和提高老年髋关节置换术后认知功能,其术后认知功能障碍的发生率较低。

Objective To investigate the effect of mental tri-needle electro-acupuncture（EA） on the postoperative cognitive dysfunction（POCD） in the elderly patients after hip joint replacement surgery. Methods A total of 120 elderly patients who would have selective whole hip joint replacement surgery were enrolled into the study. The patients were randomized into EA group and control group, 30 cases in each group. Both groups were given postoperative conventional treatment, and additionally, the treatment group was given mental tr/-needle EA 30 min before the completion of surgery, and on postoperative day 1 and 2. After the suspension of anesthesia, time for the recovery of spontaneous breathing, time for opening eyes responding for the call, time for the recovery of consciousness, and extubation time as well as the Steward scores of awakening were recorded. On postoperative day 1, 2, 3, 5, 7, we recorded the scores of Postoperative Quality Recovery Scale （PQRS） , and calculated the incidence of POCD. Results （1） Time for opening eyes responding for the call, time for the recovery of consciousness, and extubation time in the treatment group were shorter than those in the control group（P 〈 0.01）, and the Steward scores of awakening were obviously higher than that of the control group（P 〈 0.01 ）. （2） On postoperative day 1, 2, 3, 5, 7, the treatment group had higher PQRS scores than the control group （P 〈 0.01）. （3） On postoperative day 1, 2, 3, 5, 7, the treatment group had higher POCD incidence than the control group, and the difference was significant execpt for that on postoperative day 7 （P 〈 0.05）. Conclusion Mental tri-needle electro-acupuncture is effective on improving the postoperative cognitive function of the elderly patients after hip ioint replacement surgery and can decrease the POCD incidence.