| 严兆霞,许华.电针联合右美托咪定对老年骨科患者术中应激的影响[J].实用中西医结合临床,2021,21(4): |
| 电针联合右美托咪定对老年骨科患者术中应激的影响 |
| Effect of electroacupuncture combined with exmedetomidine on intraoperative stress in elderly orthopedic patients |
| 投稿时间：2020-11-16 修订日期：2021-02-10 |
| DOI： |
| 中文关键词: 电针 α2AR激动剂 针药复合麻醉 围术期 麻醉恢复 |
| 英文关键词: Electroacupuncture Alpha 2 adrenergic receptor agonist Combined acupuncture and medicine anesthesia Perioperative Period Anesthesia Recovery Period. |
| 基金项目:上海市科学技术委员会科研计划项目，基金号：16ZR1400500。 |
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| 中文摘要: |
| 目的 探讨电针联合右美托咪定对老年骨科患者术中应激的影响。方法 选择拟行下肢骨折手术的老年患者56例，年龄65～80岁，体重50～75kg。采用随机数字法分为四组（n＝14）：单纯全麻组、电针复合全麻组（简称复合电针组）、α2AR激动剂复合全麻组（简称复合右美组）及电针联合α2AR激动剂复合全麻组（简称针药复合组）。记录术中血压、心率、血氧饱和度等各项监护指标；术前、术后神经心理学指标（简易智力检查评分MMSE和疼痛视觉模拟评分VAS)及血糖；术中心血管活性药物的使用情况及患者住院天数。结果 1、术后各时间点针药复合组的MMSE值均高于单纯全麻组（p＜0.05）；2.术后72h内，针药复合组疼痛评分低于其它三组（p＜0.05）；3.针药复合组的术中循环及血糖值更稳定；4.针药复合组术后意识恢复时间最短（p＜0.05），但在术后呼吸恢复时间和住院天数的比较上，四组之间无差异（p＞0.05）；5.四组患者在心血管活性药物的使用上无差异。 结论 术中电针合谷、百会穴与右美托咪定联合应用能够稳定老年患者围术期血糖，使老年患者术中循环更加稳定，且能够减少老年患者术后认知功能障碍的发生，提示该麻醉方式可显著降低老年骨科患者术中应激。 |
| 英文摘要: |
| Objective: To explore the effect of electroacupuncture (EA) combined with dexmedetomidine on stress in elderly orthopaedic patients. Methods Fifty~six elderly patients, aged 65~80 years and weighing 50~75 kg, were selected for lower limb fracture surgery. they were randomly divided into four groups (n=14): simple general anesthesia group, electroacupuncture combined general anesthesia group (abbreviated as composite electroacupuncture group), α2AR agonist compound general anesthesia group (abbreviated as compound dextromethorphan group) and electroacupuncture combined with α 2AR agonist combined general anesthesia group (abbreviated as acupuncture and drug combination group). the intraoperative blood pressure, heart rate, oxygen saturation and other monitoring indicators; preoperative and postoperative neuropsychological indicators(Mini~mental State Examination MMSE, Visual Analogue Scale/Score VAS) and blood glucose; the use of vasoactive drugs in the operation center and the length of hospital stay were recorded.. Hospitalization Days and Intraoperative Use of Cardiovascular Active Drugs. Results 1. The MMSE value of the combined acupuncture~drug general anesthesia group at each time point was higher than that of the simple general anesthesia group(p < 0.05) ; 2.At 72 hours after operation, the VAS of the combined acupuncture~drug general group was lower than that of the other three groups (p < 0.05) ; 3. The circulation and blood glucose in the acupuncture and medicine combined group were more stable; 4. The recovery time of consciousness was the shortest in the combined acupuncture and medicine group (P < 0.05), but there was no difference between the four groups in terms of postoperative respiratory recovery time and hospitalization days (P > 0.05); 5. There was no difference in the use of cardiovascular active drugs among the four groups. Conclusion During the operation, electroacupuncture at hegu and baihui points combined with dexmedetomidine can stabilize the perioperative blood glucose of elderly patients, make the circulation of elderly patients more stable, and reduce the occurrence of postoperative cognitive dysfunction in elderly patients, suggesting that this anesthesia method can significantly reduce the stress of elderly orthopedic patients during operation. |
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