摘要
目的探讨经皮穴位电刺激(Transcutaneous electrical acupoint stimulation,TEAS)辅助全身麻醉对小儿扁桃体摘除术围拔管期应激反应和术后苏醒质量的影响。方法选取拟在全身麻醉下行扁桃体摘除术的住院患儿60例,随机分为对照组和观察组,各30例。对照组行常规静脉全麻,观察组在全麻诱导前30 min开始选取双侧合谷、足三里、三阴交行穴位刺激直至手术结束,麻醉诱导和维持方法与对照组相同。分别记录两组患儿入室时(T_0)、手术结束时(T_1),拔管前即刻(T_2)、拔管后1min(T_3)、拔管后5min(T_4)、拔管后10min(T_5)、拔管后30 min(T_6)各时间点的平均动脉压(MAP)和心率(HR);采集T_0、T_2、T_3、T_5、T_6时间点静脉血,测量血浆皮质醇(Cor)、IL6的浓度;观察术后麻醉苏醒情况和不良反应。结果两组患儿MAP、HR在T_1、T_2、T_3、T_4、T_5时刻比T_0时刻升高,有统计学意义(P<0.05),观察组T_6与T_0相比无统计学意义(P>0.05,P=0.223);相同时刻两组T_0、T_1时刻MAP、HR比较无统计学意义(P值分别为P=0.516,P=0.263),观察组T_2至T_6的MAP,HR均比对照组降低,有统计学意义(P<0.05);观察组T_6与T_0时刻相比,Cor降低有统计学意义(P<0.05,P=0.00),IL-6无统计学意义(P>0.05,P=0.152)。同一时刻观察组在T_2、T_3、T_5、T_6时刻Cor、IL6的值比对照组较低,有统计学意义(P<0.05);术后苏醒恢复情况和不良反应发生率均有统计学意义(P<0.05)。结论经皮穴位电刺激可减少扁桃体摘除术患儿全麻围拔管期的应激反应,提高患者的苏醒质量。
Objective:To study TEAS effect on stress reaction and recovery quality of children undergoing tonsillectomy with general anesthesia during extubation period. Methods: Undergoing tonsillectomy with general anesthesia, 60 hospitalized children were randomly divided into control and observation groups, with 30 cases in each. The control group received routine intravenous anesthesia, while in observation group, children were given TEAS on Hegu (LM), Zusanli (ST36) and Sanyinjiao (SP6) of both sides from 30 minutes before general anesthesia induction ( the inducing and sustaining method of it was same as the control group ) to the end of operations. Mean arterial pressure (MAP) and heart rate (HR) when children went into operating room (T0), at the end of operation (T1), before drawing tubes (T2), after 1 min, 5min, 10min and 30min of tube drawing(T3, T4, T5 and T6) were recorded in the two groups; venous bloods were drew at TO, T2, T3, T5 and T6, the concentrations of plasma cortisol (Cor) and IL6 tested, as well as children' s recovery and adverse reactions from anesthesia observed after operation. Results: The result, MAP and HR at T1, T2, T3, T4 and T5 of two groups being higher than those at TO, had statistical meaning ( P〈0.05), while the comparison of T6 and TO in the observation group had no statistical meaning ( P〉0.05, P = 0.223 ) ; the comparison of MAP and HR at TO and T1 in two groups had no statistical meaning (P=0.516, P=0. 263), while MAP and HR at T2 and T6 in observation group were beth lower that those in control group, which had statistical meaning ( P〈0.05 ) ; Cot at T6 and T0 in observation group were decreased, which had statistical meaning (P〈0.05, P = 0.00), while IL-6 had no statistical meaning (P〉0.05, P = 0.152). Cor and IL5 at T2, T3, T5 and T6 in observation group were lower than those in control group, which had statistical meaning ( P〈 0.05 ) ; the comparison of recovery condition after operation and rates of adverse reaction had statistical meaning (P〈0.05). Conclusion: TEAS can lessen stress response of children undergoing tonsillectomy with general anesthesia during extubation period and improve their recovery quality.
出处
《现代中医药》
CAS
2017年第2期47-51,共5页
Modern Chinese Medicine