| 引用本文:刘智，滕永杰，何慧鑫.针刺麻醉与气体麻醉对老年患者术后认知功能障碍及NSE、S-100β蛋白水平变化的影响[J].世界中医药,2018,(11):. |
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| 针刺麻醉与气体麻醉对老年患者术后认知功能障碍及NSE、S-100β蛋白水平变化的影响 |
| Effects of Acupuncture Anesthesia and Gas Anesthesia on Elderly Patients with Postoperative Cognitive Dysfunction and NSE，S-100β Protein Levels Change |
| 投稿时间：2017-01-10 |
| DOI：10.3969/j.issn.1673-7202.2018.11.048 |
| 中文关键词: 针刺麻醉 气体麻醉 老年患者 认知功能 NES S-100β |
| English Keywords:Acupuncture anesthesia Gas anesthesia Elderly patients Cognitive function NES S-100β |
| 基金项目:湖南省科技厅重点研发项目(2015JC3071)——针灸对乳腺癌患者围术期镇痛和免疫功能的影响 |
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| 中文摘要: |
| 目的:探究针刺麻醉与气体麻醉联合对老年患者术后认知功能障碍及对NSE、S-100β蛋白水平的影响。方法:选取2015年1月至2016年9月湖南省中医药大学第一附属医院收治与标准相符的手术老年患者99例。随机盲法将患者分为观察组(n＝50)和对照组(n＝49)。观察组术前对百会穴、内关穴、足三里穴、三阴交穴等进行预先行电针,并实施全麻和吸入七氯烷维持麻醉,过程一直保持电针不变。对照组在全麻基础上仅吸入七氯烷维持麻醉。比较2组手术前24 h及术后1 h、24 h的简易智能量表(MMSE)所评定的认知功能改变;检测2组患者手术开始前24 h、手术结束时、手术24 h的血清NSE、S-100β蛋白变化。结果:与对照组比较,观察组术后1 h MMSE评分显著升高(P<0.05),认知功能障碍(POCD)和躁动症发生率显著减少(P<0.05)。与对照组比较,在手术1 h和手术24 h后,观察组的颈内静脉血清NSE、S-100β蛋白浓度显著降低(P<0.05)。结论：针刺麻醉联合气体麻醉优于单纯气体麻醉,由于老年人神经系统的脆弱性,联合麻醉能够减轻麻醉对神经系统的损伤,进一步加快认知功能的修复,降低术后认知功能发生率,具有较好的临床应用价值。 |
| English Summary: |
| To explore the effects of acupuncture anesthesia with gas anesthesia on elderly patients with postoperative cognitive dysfunction and protein levels of NSE，S-100β.Methods:A total of 99 cases of elderly patients in conformity with standards of surgery in The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 2015 to September 2016 were collected.The patients were divided into observation group (50 cases) and control group (49 cases) by random blind method.The observation group received preoperative electroacupuncture of baihui acupoint (GV20)，neiguan acupoint (PC6)，zusanli acupoint (ST36)，and sanyinjiao acupoint (SP6) of in advance，and the general anesthesia was performed and maintained by inhaling heptachlor.The process of electroacupuncture remained unchanged.On the basis of general anesthesia，the control group maintained anesthesia by inhaling heptachlor.The assessment of cognitive function change by Mini-mental State Examination (MMSE) 24 h before surgery and 1 h，24 h after surgery of two groups were compared.The changes of the NSE and S-100β protein in serum of two groups of patients 24 h before surgery，the end of the surgery，24 h after the surgery were detected.Results:Compared with the control group，the MMSE score of the observation group was significantly increased 1 h after surgery (P<0.05)，and the incidence of Postoperative Cognitive Deficit (POCD) and restless syndrome was significantly reduced (P<0.05).Compared with control group，in 1 h and 24 h after the surgery，the internal jugular vein serum NSE，S-100β protein concentrations of the observation group were decreased significantly (P<0.05).Conclusion:Acupuncture anesthesia combined gas anesthesia is superior to the pure gas anesthesia.Because of the fragility of the elder's nervous system，combined anesthesia can mitigate the damage of anesthesia on the nervous system，further speed up the repair of cognitive function，reduce the incidence of postoperative cognitive function and has good clinical application value. |
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