经穴电针刺激麻醉对老年直肠癌根治术患者麻醉效果、应激反应及免疫功能的影响

Effects of Electroacupuncture Stimulation Anesthesia at Acupoints on Anesthesia Effect,Stress Response and Immune Function in Elderly Patients Undergoing Radical Resection of Rectal Cancer

目的:观察经穴电针刺激麻醉对老年直肠癌根治术患者麻醉效果、应激反应及免疫功能的影响。方法:采用随机数字表法将2022年1月~2023年5月期间在我院行直肠癌根治术的97例老年患者分为对照组(n=48,全凭静脉麻醉)和观察组(n=49,对照组的基础上接受经穴电针刺激麻醉)。对比两组麻醉药物追加量、血流动力学、疼痛评分、免疫功能指标、应激反应指标和不良反应情况。结果:与对照组相比,观察组的罗库溴铵用量、丙泊酚用量、瑞芬太尼用量更少(P<0.05)。与对照组相比,观察组麻醉诱导期(T1)~麻醉结束时(T3)时间点平均动脉压、呼吸频率更低(P<0.05)。与对照组相比,观察组术后6 h、12 h、24 h的疼痛视觉模拟评分(VAS)更低(P<0.05)。与对照组相比,观察组术毕CD8+更低,CD4+、自然杀伤(NK)细胞、CD4+/CD8+更高,去甲肾上腺素、肾上腺、皮质醇更低(P<0.05)。两组不良反应发生率组间对比未见差异(P>0.05)。结论:经穴电针刺激麻醉用于老年直肠癌根治术患者,可减少其他麻醉药物的用药量,减轻疼痛,维持血流动力学稳定,减轻应激反应,改善免疫抑制,具有良好的麻醉效果。

Objective:To observe the effects of electroacupuncture stimulation anesthesia at acupoints on anesthesia effect,stress response and immune function in elderly patients undergoing radical resection of rectal cancer.Methods:97 elderly patients who underwent radical resection of rectal cancer in our hospital from January 2022 to May 2023 were divided into control group(n=48,total intravenous anesthesia)and observation group(n=49,on the basis of control group received electroacupuncture stimulation anesthesia at acupoints)by random number table method.The additional amount of anesthetic drugs,hemodynamics,pain score,Immune function indicators,stress response indicators and adverse reactions were compared between two groups.Results:Compared with control group,the dosage of vecuronium bromide,propofol and remifentanil in observation group were less(P<0.05).Compared with control group,the mean arterial pressure and respiratory rate in observation group were lower at the time points from anesthesia induction period(T1)to the end of anesthesia(T3)(P<0.05).Compared with control group,the pain visual analogue score(VAS)in observation group was lower at 6 h,12 h and 24 h after operation(P<0.05).Compared with control group,CD8+in observation group was lower,CD4+,natural killer(NK)cells,CD4+/CD8+were higher,and norepinephrine,adrenal gland and cortisol were lower(P<0.05).There was no difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion:Electroacupuncture stimulation anesthesia at acupoints for elderly patients undergoing radical resection of rectal cancer,which can reduce the dosage of other anesthetics,relieve pain,maintain hemodynamic stability,reduce stress response,improve immunosuppression,and have good anesthetic effect.