中华麻醉学杂志2024，Vol.44Issue(10) ：1231-1234.DOI:10.3760/cma.j.cn131073.20240402.01016

经皮穴位电刺激对腹腔镜子宫全切术患者颅内压的影响:测量视神经鞘直径

Effect of transcutaneous electrical acupoint stimulation on intracranial pressure in patients undergo-ing laparoscopic hysterectomy:measurement of optic nerve sheath diameter

张怡 梁晶光 朱建坡 王雪娜 李一 张娥 姜丽华
中华麻醉学杂志2024，Vol.44Issue(10) ：1231-1234.DOI:10.3760/cma.j.cn131073.20240402.01016
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经皮穴位电刺激对腹腔镜子宫全切术患者颅内压的影响:测量视神经鞘直径

Effect of transcutaneous electrical acupoint stimulation on intracranial pressure in patients undergo-ing laparoscopic hysterectomy:measurement of optic nerve sheath diameter

张怡 1梁晶光 1朱建坡 1王雪娜 1李一 1张娥 2姜丽华3
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作者信息

  • 1. 河南中医药大学第一附属医院麻醉科,郑州 450000
  • 2. 河南中医药大学第一附属医院妇产科,郑州 450000
  • 3. 郑州大学第三附属医院麻醉科,郑州 450000
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摘要

目的 通过超声测量视神经鞘直径评价经皮穴位电刺激对腹腔镜子宫全切术患者颅内压的影响.方法 择期拟行腹腔镜子宫全切术患者42例,年龄18-60岁,ASA分级Ⅰ或Ⅱ级,BMI 18-28 kg/m2.采用随机数字表法将患者分为2组(n=21):对照组(C组)和经皮穴位电刺激组(T组).T组麻醉前30 min选择鱼腰穴、太阳穴实施经皮穴位电刺激,电流频率为2/100 Hz的疏密波交替,电流强度从1 mA开始,至患者体感疼痛时所能承受最大电流,术中维持合谷穴、颧髎穴、风池穴电刺激至术毕停止.C组患者仅在对应穴位粘贴电极片,不行电刺激.于入室(T0)、麻醉诱导后3min(T1)、头低脚高位5 min(T2)、头低脚高位30 min(T3)、头低脚高位60 min(T4)和术毕即刻(T5)时测量视神经鞘直径.结果 与T0时比较,C组T3-5时和T组T4,5时视神经鞘直径升高(P＜0.05);T组T4,5时视神经鞘直径低于C组(P＜0.05).结论 经皮穴位电刺激可在一定程度上降低腹腔镜子宫全切术患者的颅内压.

Abstract

Objective To evaluate the effect of transcutaneous electrical acupoint stimulation(TEAS)on the intracranial pressure in patients undergoing laparoscopic hysterectomy by measuring the optic nerve sheath diameter(ONSD)via ultrasound.Methods Forty-two American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients,aged 18-60 yr,with a body mass index of 18-28 kg/m2,sched-uled for elective laparoscopic hysterectomy,were divided into 2 groups(n=21 each)using a random number table method:control group(group C)and TEAS group(group T).In group T,TEAS was applied to the Yintang(EX-HN3)and Taiyang(EX-HN5)acupoints at 30 min before anesthesia,the stimulation used al-ternating dense-disperse waves at a frequency of 2/100 Hz,with the current intensity starting at 1 mA and in-creasing to the maximum tolerable level just below the pain threshold,and stimulation was maintained at the Hegu(LI4),Quanliao(SI18),and Fengchi(GB20)acupoints during surgery until the procedure was com-pleted.Patients had electrode pads applied to the corresponding acupoints without electrical stimulation in group C.The ONSD was measured upon entry into the operating room(T0),3 min after anesthesia induction(T1),5 min after trendelenburg position(T2),30 min after trendelenburg position(T3),60 min after tren-delenburg position(T4),and immediately after the end of operation(T5).Results Compared to the base-line at T0,the ONSD was significantly increased at T3-5 in group C and at T4,5 in group T(P＜0.05).The ONSD was significantly lower at T4 5 in group T than in group C(P＜0.05).Conclusions TEAS can reduce the intracranial pressure to some extent in patients undergoing laparoscopic hysterectomy.

关键词

电刺激疗法/腹腔镜/子宫切除术/颅内压/视神经鞘直径

Key words

Electric stimulation therapy/Laparoscopes/Hysterectomy/Intracranial pres-sure/Optic nerve sheath diameter

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基金项目

河南省中医药科学研究专项课题(2022JDZX054)

出版年

2024
中华麻醉学杂志
中华医学会

中华麻醉学杂志

CSTPCDCSCD北大核心
影响因子：1.235
ISSN：0254-1416
参考文献量14
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