经皮穴位电刺激对食管癌根治术围手术期患者肺部并发症的影响

Effect of Percutaneous Acupoint Electrical Stimulation on Pulmonary Complications in Patients Undergoing Radical Resection of Esophageal Carcinoma

目的:探讨经皮穴位电刺激对食管癌根治术患者肺部并发症的影响。方法:选择2019年1月—2021年2月在本院接受胸腹腔镜下根治术治疗的64例食管癌患者,随机分为观察组和对照组各32例,观察组患者于麻醉诱导前30 min选取足三里穴、合谷穴、肺俞穴给予经皮穴位电刺激,持续刺激30 min,对照组在相同穴位处贴放电极片,但不输出电流,比较两组患者PaO_(2)/FiO_(2)(氧合指数)、A-aDO_(2)(肺泡动脉氧分压差)、肺部并发症发生率、血清炎性因子(TNF-α、IL-6、CRP)水平。结果:T1、T2、T3时刻,两组患者PaO_(2)/FiO_(2)较T0时刻均明显降低(P<0.05),A-aDO_(2)较T0时刻明显增高(P<0.05),但观察组PaO_(2)/FiO_(2)明显高于对照组(P<0.05),A-aDO_(2)明显低于对照组(P<0.05)。观察组肺部并发症发生率明显低于对照组(P<0.05)。术后12、24 h两组患者TNF-α、IL-6、CRP水平较术前明显升高(P<0.05),但观察组明显低于对照组(P<0.05)。结论:经皮穴位电刺激可改善食管癌根治术患者围术期氧合指数,降低肺部并发症风险和炎症反应。

Objective: To investigate the effect of percutaneous acupoint electrical stimulation on pulmonary complications in patients undergoing radical resection of esophageal cancer. Methods:A total of 64 patients with esophageal cancer who received laparoscopic radical thoracotomy in our hospital from January 2019 to February 2021 were selected and randomly divided into observation group and control group, 32 cases in each group. The observation group was given percutaneous electrical stimulation 30 minutes before anesthesia induction, and stimulation lasted for 30 minutes. The control group placed electrodes at the same acupoints without outputting current. PaO_(2)/FiO_(2), a-ADO_(2), the incidence of pulmonary complications and the level of serum inflammatory factors were compared between the two groups. Results:At T1, T2 and T3, PaO_(2)/FiO_(2)in two groups was significantly lower than that at T0(P<0.05), and a-ADO_(2)was significantly higher than that at T0(P<0.05), but PaO_(2)/FiO_(2)in the observation group was significantly higher than that in the control group(P<0.05). a-ADO_(2)was significantly lower than that in the control group(P<0.05). The incidence of pulmonary complications in the observation group was significantly lower than that in the control group(P<0.05). The levels of TNF-α, IL-6 and CRP in the two groups 12 h and 24 h after surgery were significantly higher than those before surgery(P<0.05), but the observation group was significantly lower than those in the control group(P<0.05). Conclusion: Percutaneous electrical acupoint stimulation can improve perioperative oxygenation index, reduce the incidence of pulmonary complications and reduce the level of inflammatory factors in patients undergoing radical resection of esophageal cancer.