摘要
目的探讨针刺联合超声引导腰骶神经丛阻滞麻醉对围术期老年患者应激状态及术后认知功能的影响。方法选取医院2016年8月至2019年8月收治的拟行手术的老年患者86例,随机分为观察组和对照组,各43例。两组患者均行外科手术,术中给予超声引导腰骶神经丛阻滞麻醉,观察组患者加用针刺治疗。结果观察组患者的麻醉后监测治疗室(PACU)留置时间、术后下床活动时间、住院时间均明显短于对照组(P<0.05);观察组患者术后1 d的皮质醇(Cor)、丙二醛(MDA)水平及美国国立卫生研究院卒中量表(NIHSS)评分明显低于对照组,超氧化物歧化酶(SOD)水平及简易精神状态量表(MMSE)、格拉斯哥昏迷量表(GCS)、生活质量各维度评分均明显高于对照组(P<0.05);观察组与对照组不良反应发生率相当(16.28%比9.30%,P>0.05)。结论针刺联合超声引导腰骶神经丛阻滞麻醉用于围术期老年患者,能减轻其术后应激反应状态,改善术后的认知功能和生活质量,促进康复。
Objective To investigate the effect of acupuncture combined with ultrasound-guided lumbosacral plexus block anesthesia on oxidative stress and postoperative cognitive function of elderly patients during the perioperative period.Methods Totally 86 elderly patients scheduled for surgery in our hospital from August 2016 to August 2019 were selected and randomly divided into the observation group and the control group,43 cases in each group.The patients in the two groups underwent surgery,and they were given ultrasound-guided lumbosacral plexus block anesthesia during the surgery,on this basis,the patients in the observation group were treated with acupuncture.Results The retention time of Postanesthesia Care Unit Recovery Room(PACU),the time of getting out of bed after the surgery and the hospitalization stay in the observation group were shorter than those in the control group(P<0.05).The levels of cortisol(Cor),malondialdehyde(MDA)and the score of National Institute of Health Stroke Scale(NIHSS)in the observation group were significantly lower than those in the control group(P<0.05),while the level of superoxide dismutase(SOD),the scores of Mini-Mental State Examination(MMSE),Glasgow Coma Scale(GCS)and quality of life in the observation group were higher than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was similar to that in the control group(16.28%vs.9.30%,P>0.05).Conclusion Application of acupuncture combined with ultrasound-guided lumbosacral plexus block anesthesia in the elderly patients during the perioperative period can reduce the postoperative stress response state,improve the postoperative cognitive function and quality of life,which can promote the postoperative rehabilitation of the patients.
作者
程国强
樊风叶
王志刚
江军芳
冯蕊红
CHENG Guoqiang;FAN Fengye;WANG Zhigang;JIANG Junfang;FENG Ruihong(Shexian Hospital of Traditional Chinase Medicine,Handan,Hebei,China 056400)
出处
《中国药业》
CAS
2021年第2期68-71,共4页
China Pharmaceuticals
基金
河北省中医药管理局科研计划项目[2019390]。
关键词
老年患者
围术期
腰骶神经丛阻滞麻醉
超声
针刺治疗
氧化应激
认知功能
elderly patients
perioperative period
lumbosacral plexus block anesthesia
ultrasound
acupuncture treatment
oxidative stress
cognitive function
作者简介
第一作者:程国强,男,大学本科,主治医师,研究方向为麻醉学,(电子信箱)caijiao76943@163.com。
