针药复合麻醉对不停跳冠状动脉移植术患者围术期免疫球蛋白及补体的影响

发布时间：2018-09-05 07:26

【摘要】：目的:探讨针药复合麻醉对不停跳冠状动脉旁路移植手术患者围术期免疫球蛋白及补体的影响。方法:选择择期行不停跳冠状动脉旁路移植手术的患者50例。随机分为两组,每组25例。针药复合组(A组)25例,对照组(C组)25例。A组于麻醉诱导前30min、术中持续及术后3次(术后6h、24h、48h)行经皮穴位电刺激,频率为2Hz/100Hz,术前术后电刺激强度为引起感觉阈强度的2~3倍即10~15m A,术中麻醉期间刺激强度为30m A,刺激部位是双侧中府、云门、列缺和内关穴,30min/次;C组也以同样的装置和时间点连接在患者相同穴位上以同样频率但以较小电刺激强度4m A进行电刺激。两组患者均采用方案相同的全凭静脉麻醉。对围术期两组患者血浆免疫球蛋白Ig G、Ig A、Ig M及补体C3、C4的数据进行比较。结果:两组患者Ig G、Ig A值在术后24h、72h均较术前明显下降,Ig M、C3、C4值在术后24h较术前明显下降,术后72h恢复到术前水平;与C组相比,A组术后24h、72h Ig G、Ig A值较术前下降幅度相对较小,术后24h Ig M、C3值较术前下降幅度较小,组间差异有统计学意义(均P0.05)。结论:针药复合麻醉可有效减轻不停跳冠状动脉旁路移植术患者围术期免疫球蛋白及补体抑制,具有调节围术期机体免疫功能的作用。
[Abstract]:Objective: to investigate the effect of acupuncture and medicine combined anesthesia on immunoglobulin and complement in patients undergoing coronary artery bypass grafting. Methods: 50 patients undergoing coronary artery bypass grafting were selected. They were randomly divided into two groups, 25 cases in each group. There were 25 cases in group A and 25 cases in control group. Group A received percutaneous electrical stimulation 30 minutes before anesthesia induction and 3 times after operation (6 hours, 24 hours and 48 hours after operation). The frequency was 2 Hz / 100 Hz. The intensity of electrical stimulation before and after operation was 2 or 3 times that of sensory threshold. During anesthesia, the stimulation intensity was 30 Ma. In group C, the same device and time point were used to connect the same acupoints with the same frequency but with a small electric stimulation intensity of 4mA. Patients in both groups were treated with total intravenous anesthesia with the same regimen. The data of plasma immunoglobulin (Ig) G G Ag G M and complement C 3 C 4 were compared between the two groups during perioperative period. Results: the Ig GG A value of the two groups was significantly decreased at 24 hours after operation compared with that before operation. The value of Ig MMC C 3 C 4 decreased significantly at 24 h after operation and recovered to the preoperative level at 72 h after operation, and the decrease range of Ig IgG A at 24 h and 72 h after operation in group A was relatively small compared with that in group C, and the value of IgA in group A was significantly lower than that in group C at 24 h after operation, and the value of IgA in group A was significantly lower than that in group C. 24 hours after operation, the decrease of Ig MMA C3 was smaller than that before operation, and the difference between groups was statistically significant (P 0.05). Conclusion: combined acupuncture and medicine anesthesia can effectively reduce the immune globulin and complement inhibition in patients undergoing coronary artery bypass grafting and can regulate the immune function during perioperative period.
【作者单位】：北京首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所麻醉科;航空总医院麻醉科;
【基金】：科技部国家重点基础研究发展计划“973”资助项目(2013CB531902)
【分类号】：R654.2

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