Department of Anesthesia, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
Mediators Inflamm. 2017;2017:8369737. doi: 10.1155/2017/8369737. Epub 2017 Jul 19.
Reperfusion after tourniquet use can induce inflammation and cause remote organ injury. We evaluated the therapeutic effect of transcutaneous electrical acupoint stimulation (TEAS) on inflammatory mediators and lung function in patients receiving lower limb tourniquets. Forty patients undergoing unilateral lower extremity surgery with tourniquet were randomly assigned to two groups: the TEAS group and ischemia-reperfusion (I/R) group. The C-C motif chemokine ligand 2 (CCL2), C-X-C motif chemokine ligand 8 (CXCL8), interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor- (TNF-), and arterial blood gas analysis were measured preoperatively and 6 h after tourniquet removal. The levels of CXCL8, IL-1, IL-6, TNF-, and CCL2 were significantly increased compared to baseline values in both groups, but the increase was significantly smaller in the TEAS group. In the TEAS group, the partial pressure of oxygen and arterial-alveolar oxygen tension ratio were significantly decreased, and the alveolar-arterial oxygen tension difference and respiratory index were significantly increased, compared to those in the I/R group at 6 h after reperfusion. In conclusion, TEAS diminished the upregulation of proinflammatory factors in response to lower limb ischemia-reperfusion and improved pulmonary gas exchange.
止血带使用后的再灌注可引起炎症,并导致远处器官损伤。我们评估了经皮穴位电刺激(TEAS)对接受下肢止血带的患者的炎症介质和肺功能的治疗效果。40 例接受单侧下肢手术并使用止血带的患者被随机分配到两组:TEAS 组和缺血再灌注(I/R)组。在止血带去除后 6 小时,测量 C-C 基序趋化因子配体 2(CCL2)、C-X-C 基序趋化因子配体 8(CXCL8)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-(TNF-)和动脉血气分析。与两组的基线值相比,CXCL8、IL-1、IL-6、TNF-和 CCL2 的水平均显着升高,但 TEAS 组的升高幅度显着较小。在 TEAS 组中,与 I/R 组相比,在再灌注后 6 小时,氧分压和动脉-肺泡氧分压比显着降低,肺泡-动脉氧分压差和呼吸指数显着增加。总之,TEAS 减轻了下肢缺血再灌注后促炎因子的上调,并改善了肺气体交换。