目的 探讨经皮穴位电刺激(TEAS)对老年肝癌患者术后早期认知功能障碍(POCD)及血清相关炎症因子的影响.方法 选取本院收治的行手术治疗的100例肝癌患者,使用随机数字表法分为两组(各50例),TEAS组从麻醉前开始至术毕始终给予TEAS,对照组不进行电流刺激.记录围术期指标、术后疼痛程度、POCD发生情况,并比较两组手术前后的血清S-100β蛋白(S-100β)、神经元特异性烯醇化酶(NSE)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平变化.结果 两组的围术期指标及术后24 h VAS评分接近(P＞0.05).与对照组相比,TEAS组的丙泊酚用量、瑞芬太尼用量均明显更少(P＜0.05).与术前1 d相比,两组术后1、3、7 d MMSE评分更低,且组间对比显示TEAS组的MMSE评分更高(P＜0.05).TEAS组的POCD总发生率(24.00％)明显比对照组(68.00％)更低(P＜0.05).与术前1 d相比,两组患者术后1 d的血清S-100β、NSE、IL-6及TNF-α水平均显著升高(P＜0.05),且TEAS组术后1 d的血清S-100β、NSE、IL-6及TNF-α水平较对照组更低.TEAS组术后的不良反应总发生率显著低于对照组(P＜0.05).结论 在老年肝癌患者术中行TEAS治疗可发挥镇痛作用,同时还能降低炎症因子水平,减轻脑损伤,降低POCD的发生风险,有利于患者的术后康复.
Influence of Transcutaneous Electrical Acupoint Stimulation on Early Postoperative Cognitive Dysfunction and Serum Inflammatory Factors in Elderly Liver Cancer Patients
Objective:To investigate the influence of transcutaneous electrical acupoint stimulation(TEAS)on early postoperative cognitive dysfunction(POCD)and serum inflammatory factors in elderly liver cancer patients.Methods:A total of 100 patients with liver cancer who were treated surgically in our hospital were randomly divid-ed into two groups by random number table method,50 cases in each group.TEAS was given to the TEAS group from the beginning of anesthesia to the end of surgery,and no electrical stimulation was given to the control group.The perioperative indexes,postoperative pain degree and POCD occurrence in the two groups were recorded,and the changes of serum soluble protein-100β(S-100β),neuron-specific enolase(NSE),interleukin-6(IL-6)and tu-mor necrosis factor-α(TNF-α)levels before and after operation in the two groups were compared.Results:The perioperative indexes and postoperative VAS scores of the two groups were similar(P＞0.05).Compared with the control group,the dosage of propofol and remifentanil in TEAS group was significantly lower(P＜0.05).Compared with the preoperative 1 d,the MMSE scores measured at each time point(1,3 and 7 d)postoperatively in the two groups were lower,and the MMSE scores in TEAS group were higher(P＜0.05).The total incidence of POCD in TEAS group(24.00％)was significantly lower than that in control group(68.00％)(P＜0.05).Compared with preop-erative 1 d,the levels of serum S-100β,NSE,IL-6 and TNF-α in the two groups 1 day postoperatively were sig-nificantly increased(P＜0.05).Compared with the control group,the levels of serum S-100β,NSE,IL-6 and TNF-α in TEAS group 1 d postoperatively were significantly lower(P＜0.05).The total incidence of adverse reactions in TEAS group was significantly lower than that in control group(P＜0.05).Conclusion:TEAS treatment in elder-ly patients with liver cancer during operation can play an analgesic role;meanwhile,it can reduce the level of in-flammatory factors,reduce brain damage,reduce the risk of POCD,which is conducive to postoperative rehabilita-tion of patients.
Partial hepatectomyCognitive dysfunctionTranscutaneous electrical acupoint stimulationInflamma-tory factorsNeuron specific enolase
NETL
NSTL
万方数据
维普
