Chi Hao, Zhou Wen-Xiong, Wu Yao-Yao, Chen Tong-Yu, Ge Wen, Yuan Lan, Shen Wei-Dong, Zhou Jia
Zhen Ci Yan Jiu. 2014 Feb;39(1):1-6.
To determine whether electroacupuncture (EA) intervention combined with general anesthesia (GA) strategy can reduce early post-operative morbidity and medical costs in patients undergoing heart valve replacement operation under cardiopulmonary bypass.
A total of 160 heart valve replacement surgery patients undergoing cardiopulmonary bypass were randomly divided into GA and EA + GA groups (n = 80 in each group). Patients of the GA group were given with intravenous injection of Fentanyl, Midazolam, Vecuronium Bromide, etc. and routine tracheal intubation. EA (3-4 Hz, 2.0-2.2 mA) was applied to bilateral Zhongfu (LU 1), Chize (LU 5) and Ximen (PC 4) beginning about 20 mm before the surgery in the EA + GA group. Endotracheal intubation was not employed but only prepared as a standby for patients of the EA + GA group. The dosage of narcotic drugs, duration of surgery, duration of aertic blockage, rate of cardiac re-beating, volumes of post-operative blood transfusion, discharge volume, cases of post-operative pulmonary infection, vocal cord injury, and the time of first bed-off, first eating and duration in intensive care unit (IOU) residence. etc. were recorded.
The successful rates of heart valve replacement surgery were similar in both GA and EA + GA groups. Compared with the GA group, the dosages of Fentanyl, Midazolam and Vecuronium of the EA + GA group were significantly lower (P < 0.05, P < 0.01), the numbers of patients needing blood-transfusion, antibiotics treatment, and suffering from pulmonary infection were fewer, the time of first bed-off and duration of hospitalizetion and IOU residence were considerably shorter (P < 0.05, P < 0.01) and the total medical cost was obviously lower (P < 0.05) in the EA + GA group.
EA combined with general anesthesia strategy for heart valve replacement surgery without endotracheal intubation is safe and can reduce post-operative morbidity and medical costs in patients undergoing heart valve replacement surgery under cardiopulmonary bypass.
确定电针(EA)干预联合全身麻醉(GA)策略是否能降低体外循环下心脏瓣膜置换手术患者术后早期发病率及医疗费用。
选取160例行体外循环心脏瓣膜置换手术的患者,随机分为GA组和EA + GA组(每组80例)。GA组患者静脉注射芬太尼、咪达唑仑、维库溴铵等并常规气管插管。EA + GA组在手术开始前约20分钟对双侧中府(LU 1)、尺泽(LU 5)和郄门(PC 4)施加电针(3 - 4 Hz,2.0 - 2.2 mA)。EA + GA组患者不进行气管插管,仅做好备用准备。记录麻醉药物用量、手术时长主动脉阻断时间、心脏复跳率、术后输血量、引流量、术后肺部感染例数、声带损伤情况以及首次离床时间、首次进食时间和重症监护病房(ICU)住院时长等。
GA组和EA + GA组心脏瓣膜置换手术成功率相似。与GA组相比,EA + GA组芬太尼、咪达唑仑和维库溴铵用量显著降低(P < 0. 如果您还有其他需求,请随时告诉我。05,P < 0.01),需要输血、抗生素治疗及发生肺部感染的患者数量更少,首次离床时间、住院时长和ICU住院时长明显缩短(P < 0.05,P < 0.01),且EA + GA组总医疗费用明显更低(P < 0.05)。
EA联合全身麻醉策略用于无气管插管的心脏瓣膜置换手术是安全的,可降低体外循环下心脏瓣膜置换手术患者的术后发病率及医疗费用。