经皮穴位电刺激对剖宫产产妇心率变异性的影响以及麻醉后低血压防治效果的研究

Efficacy of percutaneous acupoint electrical stimulation on heart rate variability in cesarean section and prevention of hypotension after anesthesia

目的:观察经皮穴位电刺激(Transcutaneous Electrical Acupoint Stimulation,TEAS)对剖宫产产妇心率变异性(Heart Rate Variability,HRV)的影响以及麻醉后低血压的防治效果。方法:将择期剖宫产产妇120名,随机分为T组和C组,每组各60例。T组于麻醉前10 mins开始接受经皮内关穴电刺激,持续30 mins;C组仅在同样部位连接电极但不予电刺激。两组均采用腰硬联合麻醉,麻醉过程及药物剂量均保持一致。结果:与T0相比,两组T1、T2、T3的低频段(LF)、低频段/高频段(LF/HF)均有所下降(P<0.05);与C组相比,T组T1、T2、T3的LF、LF/HF较高,低血压、恶心呕吐、头晕、胸闷、呼吸困难的发生率及去氧肾上腺素使用率降低,患者满意度提高,P<0.05。结论:经皮穴位电刺激能明显提高剖宫产产妇心率变异性,降低麻醉后低血压和不良反应的发生率。

Objective:To observe the effect of transcutaneous electrical acupoint stimulation on heart rate variability in cesarean section and prevention of hypotension after anesthesia.Methods:120 women undergoing elective cesarean section were randomly divided into T group(TEAS group)and C group(control group),60 cases in each group.In T group,10 mins before anesthesia,electrical stimulation was started in the intradermal point for 30 mins.In C group,the electrodes were connected only at the same site but no electrical stimulation.Both groups were treated with combined spinal and epidural anesthesia,and the anesthesia process and drug dose were consistent.Results:Compared with T0,LF and LF/HF of T1,T2 and T3 were decreased in both groups(P<0.05).Compared with group C,LF and LF/HF of T1,T2 and T3 in group T were higher than those in group C.Hypotension,nausea and vomiting,dizziness,chest tightness,incidence of dyspnea,and decreased use of phenylephrine,patient satisfaction were increased,P<0.05.Conclusion:Transcutaneous acupoint electrical stimulation can significantly improve the variability of heart rate in cesarean section and reduce the incidence of hypotension and adverse reactions after anesthesia.