针药复合麻醉对乳腺癌改良根治术应激反应的影响
|
摘要
目的:观察针药复合麻醉对接受乳腺癌改良根治术患者血流动力学、血糖和IL-6的影响。方法:收集40例行乳腺癌改良根治术的患者,随机分为治疗组和对照组,每组20例。所有患者均行乳腺癌改良根治术,对照组使用常规麻醉,治疗组在对照组基础上予针刺麻醉,针刺点选择为双侧太冲、三阴交、内关、足三里和膻中,并用电针持续刺激约半小时。记录两组术前5 min(T1)、切皮后5 min(T2)、手术开始后2 h(T3)、术毕2 h(T4)血压、心率,监测术前5 min(T1)、术毕2 h(T4)、术后24 h(T5)血糖、IL-6。结果:治疗组T2、T3、T4舒张压、收缩压、心率变化优于对照组,治疗组T4、T5时段IL-6和血糖稳定,波动范围小。结论:针药复合麻醉可减少乳腺癌改良根治术的应激反应,加快术后康复。
Objective: To observe the efficacy of acupuncture combined general anesthesia on hemodynamics,blood glucose, Il-6 changes in breast cancer patients who undergoing modified radical mastectomy. Method: A total of 40 breast cancer patients who scheduled for modified radical, were randomly divided into control and treatment groups, 20 cases in each group. All patients had modified radical mastectomy. Patients were given routine anesthesia in control group, while the treatment group was given acupuncture anesthesia on the basis of the control group. The acupuncture points were selected as Taichong(LR3), Sanyinjiao(SP6), Neiguan(PC6), Zusanli(ST36) and Danzhong(RN17), and the electric acupuncture were continuously stimulated half an hour. Blood pressure and heart rate were measured at 5 min before surgery(T1), 5 min after skin incision(T2), 2 h after incision(T3) and 2 h postoperatively(T4). Blood glucose and Il-6 was measured in T1, T4 and 24 h postoperatively(T5). Results: The treatment group showed better diastolic pressure, systolic pressure and heart rate changes than control group at T2, T3 and T4. T he blood glucose and IL-6 was more stable in treatment group. Conclusion: Acupuncture combined general anesthesia can reduce stress response in breast cancer patients who undergoing radical mastectomy surgery and accelerate postoperative rehabilitation.
Objective: To observe the efficacy of acupuncture combined general anesthesia on hemodynamics,blood glucose, Il-6 changes in breast cancer patients who undergoing modified radical mastectomy. Method: A total of 40 breast cancer patients who scheduled for modified radical, were randomly divided into control and treatment groups, 20 cases in each group. All patients had modified radical mastectomy. Patients were given routine anesthesia in control group, while the treatment group was given acupuncture anesthesia on the basis of the control group. The acupuncture points were selected as Taichong(LR3), Sanyinjiao(SP6), Neiguan(PC6), Zusanli(ST36) and Danzhong(RN17), and the electric acupuncture were continuously stimulated half an hour. Blood pressure and heart rate were measured at 5 min before surgery(T1), 5 min after skin incision(T2), 2 h after incision(T3) and 2 h postoperatively(T4). Blood glucose and Il-6 was measured in T1, T4 and 24 h postoperatively(T5). Results: The treatment group showed better diastolic pressure, systolic pressure and heart rate changes than control group at T2, T3 and T4. T he blood glucose and IL-6 was more stable in treatment group. Conclusion: Acupuncture combined general anesthesia can reduce stress response in breast cancer patients who undergoing radical mastectomy surgery and accelerate postoperative rehabilitation.
引文
[1] Sun Y,Wang Y,Zhang L,et al. Prevention of cardiac events caused by surgical stress in aged rats:simultaneously activating beta 2-adrenoceptor and inhibiting beta1-adrenoceptor[J]. Stress,2014,17(4):373-381.
[2] Yue N,Li B,Yang L,et al. Electro-Acupuncture Alleviates Chronic Unpredictable Stress-Induced Depressive-and Anxiety-Like Behavior and Hippocampal Neuroinflammation in Rat Model of Depression[J].Front Mol Neurosci,2018,31(149):1-13.
[3] Cook D J,Reeve B K,Guyatt G H,et al. Stress ulcer prophylaxis in critically iii patients:Resolving discordant meta-analyses[J].JAMA,1996,275(4):308-314.
[4] Herszényi L, Juhász M, Mihály E, et al. Peptic ulcer disease and stress[J].Orv Hetil,2015,156(35):1426-1429.
[5] Hu D,Denney J,Liang M,et al. Stimulatory Toll-like receptor 2 suppresses restraint stress-induced immune suppression[J].Cell Immunol,2013,283(112):18-24.
[6] Dos Reis D G, Fortaleza E A, Tavares R F, et al.Role of the autonomic nervous system and baroreflex in stress-evoked cardiovascular responses in rats[J].Stress,2014,17(4):362-372.
[7] Clark W C, Yang J C, Janal M N. Altered pain and visual sensitivity in humans:The effects of acute and chronic stress[J].Ann N Y Acad Sci,1986(467):116-129.
[8] Wang S J,Zhang J J,Yang H Y. Acupoint specificity on acupuncture regulation of hypothalamic-pituitary-adrenal cortex axis function[J].BMC Complement Altern Med,2015,27(15):87.
[2] Yue N,Li B,Yang L,et al. Electro-Acupuncture Alleviates Chronic Unpredictable Stress-Induced Depressive-and Anxiety-Like Behavior and Hippocampal Neuroinflammation in Rat Model of Depression[J].Front Mol Neurosci,2018,31(149):1-13.
[3] Cook D J,Reeve B K,Guyatt G H,et al. Stress ulcer prophylaxis in critically iii patients:Resolving discordant meta-analyses[J].JAMA,1996,275(4):308-314.
[4] Herszényi L, Juhász M, Mihály E, et al. Peptic ulcer disease and stress[J].Orv Hetil,2015,156(35):1426-1429.
[5] Hu D,Denney J,Liang M,et al. Stimulatory Toll-like receptor 2 suppresses restraint stress-induced immune suppression[J].Cell Immunol,2013,283(112):18-24.
[6] Dos Reis D G, Fortaleza E A, Tavares R F, et al.Role of the autonomic nervous system and baroreflex in stress-evoked cardiovascular responses in rats[J].Stress,2014,17(4):362-372.
[7] Clark W C, Yang J C, Janal M N. Altered pain and visual sensitivity in humans:The effects of acute and chronic stress[J].Ann N Y Acad Sci,1986(467):116-129.
[8] Wang S J,Zhang J J,Yang H Y. Acupoint specificity on acupuncture regulation of hypothalamic-pituitary-adrenal cortex axis function[J].BMC Complement Altern Med,2015,27(15):87.