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电针预处理对心脏外科手术患者早期认知功能障碍的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2009年第5期
页码:
712-715
栏目:
临床研究
出版日期:
2009-07-14

文章信息/Info

Title:
Influence of electroacupuncture preconditioning on early cognitive disturbance in patients undergoing cardiac surgery
作者:
杨丽芳; 熊利泽; 路志红; 王强; 陈敏; 汪惠文; 李扬
第四军医大学西京医院麻醉科，陕西 西安 710032
Author(s):
YANG Li-fang;  XIONG Li-ze;  LU Zhi-hong;  WANG Qiang;  CHEN Min;  WANG Hui-wen;  LI Yang
Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xian 710032, Shaanxi, China
关键词:
电针预处理; 术后认知功能障碍; 体外循环; 心脏手术
Keywords:
electroacupuncture preconditioning;  postoperative cognition disorders;  cardiopulmonary bypass;  heart operation
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的: 观察术前给予电针预处理对全麻体外循环下行冠状动脉搭桥术和心脏瓣膜置换术的患者早期认知功能障碍（POCD）发生率的影响。方法: 选择择期在全麻体外循环下行冠状动脉搭桥术和心脏瓣膜置换术的患者106（男49，女57）例，随机将其分为电针预处理组和对照组两组。电针预处理组在术前连续5 d给予电针预处理，取患者双侧“内关”(PC6)、“列缺”(LU7)、“云门”(LU2)穴给予电针预处理（“华佗”牌SDZ-Ⅱ型电子针疗仪,苏州医疗用品有限公司），30 min/d。分别在术前、术后7 d及术后14 d对所有患者进行神经心理学评估，采用简易智力量表、数字符号测试、数字广度测试、循环连线测试和小故事记忆测试5项测试。结果: 因各种原因实际参与完整评估的患者共75例，其中电针预处理组38例，对照组37例。两组患者的年龄、性别、身高、体质量、受教育年限等等一般资料及手术时间和麻醉药物总量差异均无统计学意义。电针预处理组与对照组术后7 d POCD发生率分别为26％和24％，术后14 d POCD的发生率分别为10％和14％，两组间差异无统计学意义。结论: 术前给予电针预处理对全麻体外循环下行冠状动脉搭桥术和心脏瓣膜置换术的患者早期认知功能障碍发生率无显著影响。
Abstract:
AIM: To observe the effect of electroacupuncture (EA) preconditioning on cognitive dysfunction in patients undergoing heart valve replacement surgery and coronary artery bypass grafting (CABG) with cardiopulmonary bypass under general anesthesia. METHODS: One hundred and six patients (49 males, 57 females) were randomly allocated to EA preconditioning group and control group. EA preconditioning group was treated at bilateral Neiguan (PC 6), Lieque (LU 7) and Yunmen (LU 2) with electrical stimulation (5-30 Hz, 2.34-6.24 mA, 30 min) for 5 consecutive days before heart valve replacement surgery and CABG. Before operation and 7 days and 14 days after operation, all patients were required to undergo a battery of five neuropsychological tests including mini-mental status examination, digit span test, digit symbol test, trial-making test and short-story memory test. RESULTS: A total of 75 patients completed the tests (38 in EA group and 37 in control group). No significant differences were found in age, gender, height, weight and educational level between groups. The incidence of postoperative cognitive dysfunction in EA group and control group was 26.3% and 24.3% 7 days after operation, and 10.5% and 13.5% 14 days after operation, respectively. Statistical analysis showed no significant difference between groups. CONCLUSION: EA preconditioning has no effect on the incidence of cognitive dysfunction in patients to be treated with heart valve replacement surgery and CABG with cardiopulmonary bypass under general anesthesia.

参考文献/References

［1］ Caza N, Taha R, Qi Y, Blaise G. The effects of surgery and anesthesia on memory and cognition［J］. Prog Brain Res, 2008, 169:409-22.

［2］ Martin JF, de Melo RO, de Sousa LP. Postoperative cognitive dysfunction after cardiac surgery［J］. Rev Bras Cir Cardiovasc, 2008, 23(2):245-55.

［3］ Heyer EJ, Lee KS, Manspeizer HE, et al. Heparin-bonded cardiopulmonary bypass circuits reduce cognitive dysfuna6on［J］. J Cardiothorac Vasc Anesth, 2002, 16(1)：37-42.

［4］ Xiong L, Lu Z, Hou L, et al. Pretreatment with repeated electroacupuncture attenuates transient focal cerebral ischemic injury in rats［J］. Chinese medical journal, 2003, 116(1):108-111.

［5］ Ray PG, Meador KJ, Loring DW, et al. Central anticholinergic hypersensitivity in aging［J］. J Geriatr Psychiatry Neurol, 1992, 5(2)：72-77.

［6］ 汪惠文，杨丽芳，熊利泽，等. 东莨菪碱对飞心脏手术后老年患者早期认知功能障碍发生率的影响［J］. 第四军医大学学报， 2007， 28（12）：1125-1127.

［7］ Zhang J, Xu W. Frequent ventricular extrasystole treated by needing neiguan(PC6) plus oral administration of mexiletine-a report of 30 cases［J］. J Tradit Chin Med, 2004, 24(1):40-41.

［8］ 许灿然,孙大金,姚建玲,等. 针麻体外循环心内直视术规范化的研究［J］. 中国针灸, 1991, 11(4) :24.

［9］ Abildstrom H, Rasmussen LS, Rentowl P, et al. Cognitive dysfunction 1-2 years after non-cardiac surgery in the elderly. ISPOCD group. International Study of Post-Operative Cognitive Dysfunction［J］. Acta Anaesthesiol Scand, 2000, 44(10):1246-1251.

［10］Cook DJ, Plochl W, Orszulak TA, et al. Effect of temperature and PaCO2 on cerebral embolization during cardiopulmonary bypass in swine［J］. Ann Thor Surg, 2000, 69(2):415-420.

备注/Memo

备注/Memo:
收稿日期：2008-10-13.基金项目：陕西省社发攻关基金（2007K13-03）；陕西省中医药管理局资助课题（2005075） 通讯作者：熊利泽，主任医师，主要从事器官保护、危重病医学及麻醉学的研究Email:lxiong@fmmu.edu.cn 作者简介：杨丽芳，硕士生Email:yanglf@fmmu.edu.cn
更新日期/Last Update: 2009-07-22