电针预处理对胃癌根治术患者术后应激反应、肠黏膜功能及炎性因子水平的影响

Effect of electroacupuncture pretreatment on postoperative stress response,intestinal mucosal function and inflammatory factor levels in patients undergoing radical gastrectomy

目的探讨电针预处理联合全身麻醉对胃癌根治术患者术后应激反应、肠黏膜功能及炎性因子水平的影响。方法将96例行胃癌根治术的患者随机分为观察组和对照组,每组48例。2组患者均行全凭静脉麻醉,观察组增加电针刺激内麻点和足三里。记录2组针刺前(T_(0))和术后2、12、24、48 h(T_(1)、T_(2)、T_(3)、T_(4))时视觉模拟评分法(VAS)评分、心率、平均动脉压(MAP)、皮质醇(Cor)、去甲肾上腺素(NE)、促肾上腺皮质醇激素(ACTH)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、脂多糖(LPS)、二胺氧化酶(DAO)、D-乳酸水平。结果观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。T_(0)时,2组VAS评分、心率、MAP、Cor、NE、ACTH、CRP、IL-6、TNF-α、LPS、DAO及D-乳酸水平比较,差异无统计学意义(P>0.05);相较于T_(0)时,2组T_(1)~T_(4)时上述各指标水平均上升,且观察组T_(1)~T_(4)时上述各指标水平低于对照组,差异有统计学意义(P<0.05)。结论电针预处理联合全身麻醉可显著改善胃癌根治术患者术后应激反应及炎性反应,并可调节肠黏膜功能。

Objective To explore the effects of electroacupuncture preconditioning combined with general anesthesia on postoperative stress response,intestinal mucosal function and inflammatory factor levels in patients undergoing radical gastrectomy.Methods Ninety-six patients undergoing radical gastrectomy were randomly divided into observation group and control group,with 48 cases in each group.All patients in two groups received total intravenous anesthesia,and the observation group added stimulation in the Neima point and Zusanli by electroacupuncture.Visual Analogue Scale(VAS)scores,heart rate,mean arterial pressure(MAP),cortisol(Cor),norepinephrine(NE),adrenocorticotropic hormone(ACTH),C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),lipopolysaccharide(LPS),diamine oxidase(DAO)and D-lactate levels before acupuncture(T_(0))and 2,12,24,48 hours after operation(T_(1),T_(2),T_(3) and T_(4))were recorded between the two groups.Results The total incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).At T_(0),there were no significant differences in VAS,heart rate,MAP,Cor,NE,ACTH,CRP,IL-6,TNF-α,LPS,DAO and D-lactic acid levels between the two groups(P>0.05);compared with T_(0),the levels of the above indexes in the two groups were significantly increased during T_(1) to T_(4),and the levels of the above indexes in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Electroacupuncture pretreatment combined with general anesthesia can significantly improve the postoperative stress response and inflammatory response of patients undergoing radical gastrectomy,and regulate the function of intestinal mucosa.