经皮穴位电刺激对老年腹腔镜直肠癌根治术中CO2气腹所致肝肾缺血—再灌注损伤的保护效应

Protective Effect of Transcutaneous Acupoint Electrical Stimulation on Hepatic and Renal Ischemia Reperfusion Injury by CO2 Pneumoperitoneum in Gerontal Laparoscopic Radical Resection of Rectal Cancer

目的:观察经皮穴位电刺激对老年腹腔镜直肠癌根治术中CO2气腹所致肝肾缺血-再灌注损伤的保护效应。方法:选取80例行腹腔镜下经腹直肠癌切除术的老年直肠癌患者为研究对象,随机分为对照组40例和观察组40例。对照组接受标准化全身麻醉方案,观察组在标准化全身麻醉方案基础上给予经皮穴位电刺激。比较两组手术前后缺血-再灌注损伤因子、肝功能、肾功能、胆和膀胱相关指标。结果:两组术后的MDA和NO水平均较术前明显升高(P<0.05),SOD明显降低(P<0.05);且观察组各项缺血-再灌注损伤因子的变化幅度均明显少于对照组(P<0.05)。两组术后的ALT、AST、GGT、Scr、Cys-C和KIM-1水平值均较术前明显升高(P<0.05),但观察组各项肝肾功能指标的升高幅度均明显小于对照组(P<0.05)。两组术后的TBil、TBA和RUV水平值均较术前明显升高(P<0.05),MFR明显降低(P<0.05);且观察组胆和膀胱各项指标的变化幅度均明显小于对照组(P<0.05)。结论:经皮穴位电刺激可有效降低老年腹腔镜直肠癌根治术中操作所致的损伤因子水平,减轻CO2气腹引起的肝肾缺血-再灌注损伤,发挥保护脏腑效应,可作为一种简便可行的预防肝肾脏器损伤措施应用于临床。

Objective:To observe the protective effect of transcutaneous acupoint electrical stimulation on hepatic and renal ischemia reperfusion injury by CO2 pneumoperitoneum in gerontal laparoscopic radical resection of rectal cancer.Methods:80 cases of patients treated by laparoscopic radical resection of rectal cancer were chosen as research subject.They were randomly divided into controlled group with 40 cases and observation group with 40 cases.The controlled group received standardized general anesthesia program,while the observation group received transcutaneous acupoint electrical stimulation on the basis of standardized general anesthesia program.The ischemia reperfusion injury factor,liver function,renal function,gallbladder and bladder correlated indexes of the two groups before and after operation were compared.Results:The levels of MDA and NO of the two groups after operation were both clearly higher than before(P<0.05),SOD lower than before(P<0.05).And the rangeabilitise of those ischemia reperfusion injury factors in the observation group were all less than the controlled group(P<0.05).The levels of ALT,AST,GGT,Scr,Cys-C and KIM-1 of of the two groups after operation were all obviously higher than before(P<0.05).And the rangeabilitise of those hepatic and renal indexes in the observation group were all less than the controlled group(P<0.05).The levels of TBil,TBA and RUV of the two groups after operation were all obviously higher than before(P<0.05),MFR lower than before(P<0.05).And the rangeabilitise of those gallbladder and bladder indexes in the observation group were all less than the controlled group(P<0.05).Conclusions:The transcutaneous acupoint electrical stimulation can effectively reduce the level of damage caused by gerontal laparoscopic radical resection of rectal cancer,and alleviate the ischemia reperfusion injury by CO2 pneumoperitoneum,giving play to protect viscera.It is a simple and feasible preventive measure to guard against liver and kidney injury and can apply in clinic.