| 引用本文:杨军，李思海，彭栋梁，刘世举，李瑞国.术前耳穴揿针干预对腹腔镜下结直肠肿瘤手术老年患者麻醉苏醒的影响〖JZ)〗〖HS)〗[J].世界中医药,2019,(05):. |
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| 术前耳穴揿针干预对腹腔镜下结直肠肿瘤手术老年患者麻醉苏醒的影响〖JZ)〗〖HS)〗 |
| Effects of Preoperative Auricular Acupoint Needle Intervention on Anesthetic Recovery in Elderly Patients Undergoing Laparoscopic Colorectal Cancer Surgery |
| 投稿时间：2018-12-31 |
| DOI：10.3969/j.issn.1673-7202.2019.05.052 |
| 中文关键词: 结直肠癌 耳穴揿针 全凭静脉麻醉 苏醒期躁动 炎性反应应激 |
| English Keywords:Colorectal cancer Auricular acupoint needle Total intravenous anesthesia Agitation during the recovery period Interleukin-6 Tumor necrosis factor α Cortisol Norepinephrine |
| 基金项目:河南省中医药科学研究课题(2016ZY02057) |
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| 中文摘要: |
| 目的:探讨术前耳穴揿针干预对老年腹腔镜结直肠癌根治术患者麻醉苏醒质量的影响。方法:选取2015年9月至2018年2月河南中医药大学第三附属医院收治的腹腔镜下结直肠癌根治术的老年患者119例进行回顾性分析,按麻醉方式不同分为对照组(n=62)和观察组(n=57),对照组患者接受全凭静脉麻醉,观察组患者接受术前耳穴揿针＋全凭静脉麻醉。比较2组患者苏醒时间及苏醒期不同时间点［麻醉前(T0)进入麻醉后苏醒室(PACU)后30 min(T1)、60 min(T2)、出PACU时(T3)］疼痛及躁动情况、炎性反应应激反应程度的差异。结果:观察组患者的自主呼吸恢复时间、拔管时间、定向力恢复时间均短于对照组患者(P<0.05)。T0时,2组患者VAS评分值、RSS躁动评分值,血清炎性反应因子白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)及应激激素皮质醇(Cor)、去甲肾上腺素(NE)含量的差异无统计学意义(P>0.05)。T1、T2、T3时,观察组的VAS评分值、RSS躁动评分值分别低于对照组;血清中IL-6、TNF-α、Cor、NE的含量分别低于对照组(P<0.05)。结论:老年腹腔镜结直肠癌根治术患者在全凭静脉麻醉前接受耳穴揿针干预,有助于提升患者麻醉苏醒速度并优化麻醉苏醒质量、积极维持苏醒期患者内环境稳态。 |
| English Summary: |
| To investigate the effects of preoperative auricular acupoint needle intervention on the quality of anesthetic recovery in elderly patients undergoing laparoscopic radical resection of colorectal cancer.Methods:A retrospective analysis was conducted.119 elderly patients undergoing laparoscopic radical resection of colorectal cancer admitted to the Third Affiliated Hospital of Henan University of Chinese Medicine from September 2015 to February 2018 were selected as research objects.According to different methods of anesthesia，they were divided into a control group (n＝57) and an observation group (n＝62).The patients in the control group received total intravenous anesthesia，and the patients in the observation group received preoperative auricular acupoint needle+total intravenous anesthesia.The pain，agitation in the 2 group of wake time and recovery time at different time points ［before anesthesia (T0)，30 minutes after entering the anesthesia recovery room (PACU) (T1)，60 min after entering PACU (T2)，and out of PACU (T3)］ and inflammation difference in the degree of stress response were compared.Results:The spontaneous breathing recovery time，extubation time and orientation recovery time in the observation group were shorter than those in the control group (P<0.05).At T0，there were no significant difference between the 2 groups in VAS scores，RSS agitation scores，serum inflammatory factors interleukin-6 (IL-6)，tumor necrosis factor α (TNF-α)，and stress hormone cortisol (Cor)，the content of norepinephrine (NE) (P>0.05).At T1，T2 and T3，the VAS score and RSS agitation score in the observation group were lower than those in the control group; and the serum contents of IL-6，TNF-α，Cor and NE in the observation group were lower than those in control group (P<0.05).Conclusion:Elderly patients undergoing laparoscopic radical resection of colorectal cancer receive an auricular acupoint needle intervention before total intravenous anesthesia，which can help to improve the patients' anesthesia recovery speed，optimize the quality of anesthesia recovery and actively maintain the environmental homeostasis in patients during the recovery period. |
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