经皮穴位电刺激配合全麻行异氟醚控制性降压对组织氧代谢的影响

Effects of Combined Transdermal Acupoint Electric Stimulation and Isoflurane Anesthesia on Isoflurane-Induced Hypotension and Tissue Oxygen Metabolism in Patients Undergoing Craniotomy

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中文关键词: 经皮穴位电刺激异氟醚氧代谢控制性降压

英文关键词:transdermal acupoint electric stimulation isoflurane oxygen metabolism controlled hypotension

基金项目:浙江省中医药管理局基金资助课题! (No .2 0 0 0 -C - 60 )

作者	单位
王均炉	温州医学院附属第一医院!浙江325000
谢文霞	温州医学院附属第一医院!浙江325000
张琦	温州医学院附属第一医院!浙江325000

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中文摘要:

目的 :观察经皮穴位电刺激配合全麻在脑瘤术中行异氟醚控制性降压对患者组织氧代谢的影响。方法 :选取ASA分级为Ⅰ～Ⅱ级的脑瘤择期手术患者 4 2例 ,随机均分为两组。A组为常规全麻行异氟醚控制性降压 ;B组为经皮穴位电刺激配合全麻行异氟醚控制性降压。两组术中通过加大异氟醚浓度使平均动脉压较麻醉前下降 30 %～ 4 0 % ,维持 30～ 4 5min。采用Swan Ganz漂浮导管技术 ,对比监测降压前、中、后组织氧代谢及相应血气和动脉乳酸浓度等指标。结果 :与降压前比较 ,A组、B组降压期间肺动脉混合静脉血氧饱和度和组织氧供下降 ,氧摄取率增加 ,差异均有显著性 (P <0 0 5) ;降压期间氧代谢指标变化的幅度B组均明显少于A组 (P <0 0 5)。结论 :穴位电刺激配合全麻行异氟醚控制性降压能更好地维持组织氧供需平衡。

英文摘要:

Objective: To observe the effects of combined transdermal acupoint electric stimulation and isoflurane anesthesia on isoflurane induced hypotension and tissue oxygen metabolism in patients undergoing craniotomy. Methods: Forty two patients with brain tumor of ASA physical status Ⅰ or Ⅱ and scheduled for elective surgery were randomly divided into two groups. The craniotomy was undergoing in Group A with isoflurane anesthesia, while in Group B, with combined transdermal acupoint electric stimulation (TAES) and isoflurane anesthesia. Isoflurane induced hypotension was performed in both groups by augmenting the concentration of isoflurane to lower the mean arterial pressure than before anesthesia for 30%-40% and maintain for 30-45 mins. The tissue oxygen metabolism, blood gas and arterial lactic acid level before, during and after hypotension were monitored by Swan Ganz floating catheterization. Results: As compared with before hypotension, the pulmonary arterial and mixed with venous blood oxygen saturation lowered and oxygen supply lowered, and oxygen uptake increased significantly in both groups (P<0 05), but the extent of changes in oxygen metabolic criteria in Group B were all lesser than those in Group A (P<0 05). Conclusion: Combined acupoint electric stimulation and general anesthesia could maintain the tissue oxygen supply and demand balance better in the isoflurane induced hypotension process.

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