[1]于 波,丁玲玲,陆 斌,等.经皮穴位电刺激对腹腔镜手术全麻患者脑保护及应激作用的研究*[J].陕西中医,2020,(2):241-244.
　YU Bo,DING Lingling,LU Bin,et al.Study on brain protection and oxidative stress on general anesthesia patients of laparoscopic surgery by TEAS[J].,2020,(2):241-244.
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经皮穴位电刺激对腹腔镜手术全麻患者脑保护及应激作用的研究*
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2020年2期
页码:
241-244
栏目:
针灸经络
出版日期:
2020-02-05

文章信息/Info

Title:
Study on brain protection and oxidative stress on general anesthesia patients of laparoscopic surgery by TEAS
文章编号:
DOI:〖HT5K〗10.3969/j.issn.10007369.2020.02.028
作者:
于 波; 丁玲玲; 陆 斌; 王 麒
首都医科大学附属北京中医医院麻醉科(北京 100010)
Author(s):
YU Bo; DING Lingling; LU Bin; et al.
Department of Anesthesiology,Beijing Traditional Chinese Medicine Hospital,Capital Medical University(Beijing 100010)
关键词:
经皮穴位电刺激;  腹腔镜;  麻醉;  脑保护;  应激反应
Keywords:
TEAS;  Laparoscopy;  Anesthesia;  Brain protection;  Stress response
分类号:
R614
文献标志码:
A
摘要:
目的:探讨经皮穴位电刺激(TEAS)对腹腔镜手术全麻患者脑保护及应激反应的作用。方法:选择96例在我院行腹腔镜手术的患者作为研究对象,依随机的原则分为两组,观察组(48例)在麻醉过程中应用TEAS,对照组(48例)不应用电刺激。两组均应用异丙酚和瑞芬太尼TCI全凭麻醉,观察麻醉药物使用量,术后第1、2、3天时谵妄发生率,术前、术中、术毕及术后第1、2、3天时脑源性神经营养因子(BDNF)、S-100B蛋白(S100B)、神经胶质纤维酸性蛋白(GFAP)、超氧化物歧化酶(SOD)和微小RNA497-5p(miR-497-5p)的表达。结果:观察组的麻醉药物使用量明显低于对照组(P<0.05),观察组术后3 d内谵妄发生率明显低于对照组(P<0.05),观察组与对照组在术中、术毕、术后第1、2天时BDNF、S100B、GFAP、SOD和miR-497-5p的表达差别有统计学意义(P<0.05)。结论:腹腔镜手术患者全麻时积极应用TEAS能减少麻醉药物的使用量,降低术后谵妄的发生率,减少脑损伤因子的形成,增加BDNF的分泌,降低机体的氧化应激反应。
Abstract:
Objective:To investigate the effect on brain protection and stress response in patients of laparoscopic general anesthesia by TEAS.Methods:96 patients who underwent laparoscopic surgery were selected as the study objects.96 patients were divided into two groups.Both groups were anesthetized with propofol and remifentanil TCI.Observation group(48 cases)added TEAS during anesthesia,and the control group(48 cases)did not use TEAS.The dosage of anesthetics was oberved in two groups.Incidence of delirium was observed on the 1st,2nd and 3rd day after operation.Expressions of BDNF,S-100B,GFAP,SOD and miR-497-5p were observed on before operation,during operation,finish operation,1st,2nd and 3rd day after operation.Results:The dosage of anesthetics was significantly lower in the observation group than that in the control group(P<0.05).Incidence of delirium was significantly lower in the observation group than that in the control group within 3 days(P<0.05).Expressions of BDNF,S100B,GFAP,SOD and miR-497-5p were different on during operation,finish operation,the 1st,2nd and 3rd day after operation.Conclusion:TEAS can reduce dosage of anesthetics,reduce the incidence of postoperative delirium,reduce the formation of brain injury factors,increase the secretion of BDNF,reduce oxidative stress response,should be actively used in clinical treatment.

参考文献/References:

[1] 朱俊超,滕秀飞,杨延超,等.经皮穴位电刺激与右美托咪定对腹腔镜手术患者术后早期认知功能的影响[J].中国医科大学学报,2016,45(4):345-347.
[2] 朱 聪,朱美华,张晨叶,等.经皮穴位电刺激对高血压患者围手术期应激反应的影响[J].江苏医药,2019,45(8):817-819.
[3] 涂 青,史金麟,于 虹,等.经皮穴位电刺激对全麻诱导期应激水平的影响[J].现代中西医结合杂志,2019,28(2):209-211.
[4] 张维亮,于 鹏,苏 帆.经皮穴位电刺激对气管插管应激反应的影响[J].临床麻醉学杂志,2018,34(10):949-951.
[5] 黄绍强,田复波,陈新刚.七氟烷或丙泊酚联合瑞芬太尼用于腹腔镜手术麻醉的比较[J].复旦学报:医学版,2007,34(3):409-413.
[6] 马(王丽),冯善武,汪福洲,等.舒芬太尼防治雷米芬太尼行妇科腹腔镜手术麻醉苏醒期疼痛效应[J].临床麻醉学杂志,2008,24(9):767-769.
[7] Li Y,Yu Z,Ji M,et al.A Pilot Study of the use of dexmedetomidine for the control of delirium by reducing the serum concentrations of brain-derived neurotrophic factor,neuron-specific enolase,and S100B in polytrauma patients[J].J Intensive Care Med,2019,34(8):674-681.
[8] Li Z,Jia Y,Wang Y,et al.Effects of dexmedetomidine posttreatment on BDNF and VEGF expression following cerebral ischemia/reperfusion injury in rats[J].Mol Med Rep,2018,17(4):6033-6037.
[9] 郑荣芝,童 博,张夏青,等.经皮穴位电刺激辅助快通道麻醉对于胸腔镜肺叶切除术临床研究[J].陕西中医,2018,36(6):797-799.
[10] 莫云长,陈林碧,王茜茜,等.经皮穴位电刺激对颅脑手术行控制性降压重要脏器功能的保护效应[J].温州医科大学学报,2016,34(8):547-553.
[11] 杨宗林,张玉勤,郭颖强,等.经皮穴位电刺激辅助全麻对妇科腔镜手术后胃肠功能的影响[J].陕西中医,2015,36(12):1649-1650.
[12] 马新军.全身麻醉复合硬膜外麻醉对老年患者肿瘤切除术麻醉苏醒期谵妄及术后谵妄的影响[J].检验医学与临床,2017,23(22):140-142.
[13] 袁 岚,唐 炜,王 剑,等.经皮穴位电刺激对全麻髋关节置换术老年患者控制性降压期间脑氧代谢的影响[J].针刺研究,2014,39(1):7-11.
[14] 倪剑武,蒋柳明,周一敏,等.经皮穴位电刺激对老年患者腹腔镜直肠癌切除术后认知功能的影响研究[J].中国全科医学,2015,18(12):1390-1395.
[15] 胡珍渊,方永军,徐泽彪,等.淫羊藿苷对重型颅脑损伤大鼠血清S100B蛋白和NSE水平的影响[J].陕西医学杂志,2017,46(2):8-10.
[16] 张丽慧,赵晓英,王 哲, 等.TEAS辅助麻醉对老年膝关节置换术患者术后转归的影响[J].山西医科大学学报,2018,49(10):1243-1246.
[17] 甘建辉,谷书涵,郑智文, 等.不同穴位经皮穴位电刺激应用于前列腺电切术后不良反应的比较[J].现代中西医结合杂志,2019,28(20):2254-2256.
[18] 段崇珍,鲁晓红.经皮穴位电刺激对妊娠相关性血小板减少症剖宫产患者围术期凝血功能的影响[J].陕西医学杂志,2017,46(6):723-725.
[19] 高军龙,李玉兰.浅谈经皮穴位电刺激在围麻醉期的多种作用[J].中国针灸,2015,35(3):269-273.
[20] 董 婕,李路明,郝红伟,等.经皮穴位电刺激改善疲劳的脑电研究[J].航天医学与医学工程,2007,20(6):447-450.
[21] 范学明,章放香,黄 玲, 等.TEAS联合全麻与硬膜外阻滞联合全麻对腹腔镜结直肠癌根治术患者术后恢复影响的比较[J].中华麻醉学杂志,2018,38(9):1053-1057.

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备注/Memo

备注/Memo:
*北京市科技计划课题(Z171100001017061)
更新日期/Last Update: 2020-03-31