经皮穴位电刺激对胃癌根治术患者围术期血流动力学及免疫因子水平的影响

Effect of Transcutaneous Electrical Acupoint Stimulation on Perioperative Hemodynamics and Immune Factors of Patients with Laparoscopic Radical Gastrectomy

目的探讨经皮穴位电刺激(transcutaneous electrical acupoint stimulation,TEAS)对胃癌根治术患者围术期血流动力学及免疫因子水平的影响。方法选择择期全麻行腹腔镜胃癌根治术的患者80例,ASA I或II级。随机分为观察组和对照组。于术前30 min开始对观察组患者双侧足三里、合谷及三阴交穴给予电刺激;对照组则在目标穴位贴电极片,但不给予电刺激。分别在麻醉前30 min(T0)、插管时(T1)、切皮时(T2)、气腹时(T3)、拔管时(T4)记录所有患者的HR及MAP水平;于手术前和术后第1天分别取3 mL外周静脉血用于检测血浆IL-2、IL-6及IL-10浓度水平。结果与对照组相比,观察组MAP及HR在T1、T2、T3、T4时均要更低,差异有统计学意义(P<0.05)。手术前两组患者的IL-2、IL-6及IL-10浓度水平相比较,差异无统计学意义(P>0.05);术后第1天观察组IL-2、IL-6及IL-10浓度水平高于对照组,差异有统计学意义(P<0.05)。结论TEAS能够有利于保持胃癌根治术围术期血流动力学稳定,一定程度上增加围术期IL-2、IL-6及IL-10浓度水平,增加患者围术期免疫功能,加速术后康复,发挥肿瘤抑制作用。

Objective The effect of transcutaneous electrical acupoint stimulation(TEAS)on perioperative immune function of patients with laparoscopic radical gastrectomy.Methods Eighty patients,ASA classⅠorⅡ,scheduled to undergo laparoscopic radical gastrectomy,were enrolled and randomly assigned into two groups,observation group(n=40)and control group(n=40).The patients in observation group were treated with TEAS,from 30 min prior anesthesia to extubation,on bilateral Zusanli(ST36),Hegu(LI4),Sanyinjiao(SP6).While for patients in control group,electrode tabs were placed on the same target acupoints,but TEAS wasn't performed.HR and MAP level were recorded at 30 min prior anesthesia(T0),at time of intubation(T1),skin incision(T2),pneumoperitoneum(T3),and extubation(T4).3 mL of peripheral venous blood was taken before surgery and on the first postoperative day to determine plasma IL-2,IL-6 and IL-10 concentrations.Results Compared with the control group,the observation group had lower MAP and HR at T1,T2,T3,and T4,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the concentration levels of IL-2,IL-6,and IL-10 between the two groups of patients before surgery(P>0.05);On the first day after surgery,the concentration levels of IL-2,IL-6,and IL-10 in the observation group were higher than thosein the control group,and the differences were statistically significant(P <0.05). Conclusion TEAS canbe beneficial to maintain the hemodynamic stability of radical gastric cancer,increase the concentration ofIL-2,IL-6,IL-6 and IL-10 to a certain extent,increase the perioperative immune function of patients,accelerate postoperative rehabilitation,and play the role of tumor suppression.