肿瘤局部脉冲电刺激对心电活动的影响

Effect of Tumor Local Electric-impulse Stimulation on Electrocardia Action

目的:探讨肿瘤局部脉冲电刺激对心电活动的影响及对癌性疼痛的缓解作用,寻找肿瘤患者经皮电刺激止痛的安全阈值。方法:选取自愿接受肿瘤局部脉冲电刺激治疗的实体瘤疼痛患者52例,观察心电图改变及疼痛缓解程度。结果:(1)脉冲电刺激电压在45 V时,发生偶发室上性期前收缩患者增加2例,且与脉冲电刺激相关性不能排除;脉冲电刺激电压在50 V时,偶发室上性期前收缩患者增加3例,偶发室性期前收缩患者增加2例,且与脉冲电刺激相关性不能排除;脉冲电刺激电压在45、50 V时,发现4例患者出现不同于正常形态的q Rs波群,初步认为和脉冲电刺激相关,称为脉冲电刺激诱发的融合波。(2)不同脉冲电刺激时间心律失常情况比较,差异无统计学意义(P>0.05)。(3)脉冲电刺激前后心率比较,差异无统计学意义(P>0.05)。(4)脉冲电压在35 V时,不同刺激频率间心律失常情况比较,差异无统计学意义(P>0.05)。(5)在脉冲电刺激下,肿瘤疼痛可在一定程度上缓解;35 V电压时,疼痛缓解显效率与其他电压比较,差异有统计学意义(P<0.05);第4~8天疼痛缓解情况好于第1天,差异有统计学意义(P<0.05)。(6)电压≤50 V,脉冲电刺激未致局部皮肤出现损害。结论:电压不超过40 V,频率1~3 Hz,肿瘤局部脉冲电刺激对心电活动无确切影响;刺激电压35 V,刺激时间4 d以上,止痛效果显著。

Objective：To investigate the effects of local tumor electric-impulse stimulation on electrocardia action and its effects on the relief of cancer pain.To search for the safe threshold of tumor patients through the transcetaneous electrical stimulation.Method：52 patients with solid tumor pain were selected to accept electric-impulse stimulation treatment.The changes in electrocardiogram and pain were observed.Result：（1）When 45 V voltage was selected for an experimental stimulation,occasional supraventricular extrasystoles were found in 2 new patients,but relationships with electric-impulse stimulation could not be ruled out.When 50 V voltage was selected for an experimental stimulation,occasional supraventricular extrasystoles were found in 3 new patients.Occasional ventricular extrasystoles were found in 2 new patients,the relationships with electric-impulse stimulation also could not be ruled out.When 45 V,50 V voltage were selected for an experimental stimulation,waves being different shapes from normal q Rs waves were produced in 4 patients,they were preliminary consideration related with electric-impulse stimulation,they were called the fusion waves generated by the electric-impulse stimulation.（2）The differences in the occurrence of arrhythmia among different time of electric-impulse stimulation were not statistically significant（P〉0.05）.（3）The difference in the heart rate between before and after electric-impulse stimulation was not statistically significant（P〉0.05）.（4）At the voltage of 35 V,The differences in the occurrence of arrhythmia among different stimulus frequency were not statistically significant（P〉0.05）.（5）Cancer pain could be alleviated to some extent by electric-impulse stimulation.At the voltage of 35 V,the analgesic effects were the best,compared with the other voltage,the differences were statistically significant（P〈0.05）.The pain relief situations at the fourth to eighth day were better than the first day,the differences were statistically significant（P〈0.05）.（6）When the voltage was lower or equal to 50 V,the local skin was not damaged.Conclusion：When the voltage is less than or equal to 40 V at 1-3 Hz of frequencies,local tumor electric-impulse stimulation has no obvious impact on electrocardia action.At the stimulant voltage equal to 35 V and the stimulant times more than 4 days,the pain relief effect is remarkable.