针药复合麻醉用于肾移植术50例报告

CLINCAL OBSERVATION ON COMBINED ANESTHETICS-ACUPUNCTURE ANESTHESIA IN 50 PATIENTS UNDERGOING RENAL TRANSPLANTATION

１００例终末期肾衰作肾移植手术患者随机分成针药复合组（针麻取六：主穴次，三阴交，太溪；配穴肾俞和切口旁针或足三里；并复合小剂量硬膜外阻滞）与硬膜外阻滞（对照组）各５０例。在保持患者无痛的前提下，比较两组局麻药初量和总量，针药复合组为５．６±０．３ｍｌ和１３．５±１．０ｍｌ，而对照组为１４．５±０．４ｍｌ和２５．４±１．２ｍｌ，两组间有非常显著的差异（Ｐ＜０．００１）。术中对照组的血流动力学改变较大，两组需用麻黄碱和抗胆碱药的病例数和次数分别为１和２与９和５次。移植肾泌尿时间：针药复合组较对照组快，分别为２０９±２５秒和４１０±４７秒，Ｐ＜０．００１。麻醉前后的免疫功能变化两组间无明显差异。针药复合组的麻醉效果根据硬膜外给药初量多少而定，优３１例，良１３例，优良率为８８％。

patients undergoing renal transplantation were randomly divided into two groups: group 1 is combined anesthestics-acupuncture anesthesia (points selected: ciliao,sanyinjiao, taixi together with shenshu and para-incision or zusanli, combined with small doses of epidural anesthesia) and group 2 is epidural anesthesia. There were 50 patients in each group. The amount of local anesthetics between the two groups were compared. The inital dose and the total dose were 5. 6±0. 3ml and 13. 5±1. 0ml in group 1, and 14. 5±0. 4 and 25. 4±1. 2ml in group 2. The difference was very significant (P<0. 001). During the operation the hemodynamic changes were greater in group 2. The needs of adding ephydrine and atropine were 1 & 2 in group 1, and 9 & 5 in group 2. The starting time of urination of the transplanted kidney was earlier in group 1 than in group 2, being 209±25s and 410±47s, respectively(P<0. 001).The parameters of some immunologic functions after anesthesia showed no significant difference between the two groups. The degree of satisfaction for anesthesic effect was evaluated according to the inital dose of local anesthetics in group 1, 31 were excellent and 13 were ed. The combined excellent and good rate was 88%.