Ding Yi, Su Sheng-Yong, Lin Ya-Li, Wei Yi-Tong, Cai Yuan-Chun, Shi Jun-Dan, Gao Si-Li, Mo Ke-Lin, Zhuo Jin-Yi
Department of Anesthesiology, First Affiliated Hospital of Guangxi University of CM, Nanning 530023, China.
Zhongguo Zhen Jiu. 2021 Jun 12;41(6):598-602. doi: 10.13703/j.0255-2930.20201125-0004.
To observe the protective effect of electroacupuncture (EA) at Neiguan (PC 6) on pulmonary function during one-lung ventilation (OLV) in patients with lobectomy, and explore its action mechanism.
Sixty patients with lobectomy were randomly divided into an observation group and a control group, 30 cases in each one. The patients in the control group were treated with general anesthesia, and OLV was given when surgery began; when the surgery finished, air was removed from the thoracic cavity and two-lung ventilation was performed. On the basis of the treatment in the control group, the patients in the observation group were treated with EA (disperse-dense wave, 2 Hz/100 Hz of frequency) at Neiguan (PC 6) 30 min before anesthesia induction until the end of the surgery. The pulmonary function indexes [arterial partial pressure of oxygen (PaO), oxygenation index (OI), compliance of lung (CL), respiratory index (RI)] and serum levels of superoxide dismutase (SOD), malondialdehyde (MDA), interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were observed before surgery (T), 30 min into OLV (T), 60 min into OLV (T) and after operation (T). The total incidence of complications, pressing times of postoperative patient-controlled analgesia pump in 48 h after surgery and hospital stay were compared between the two groups.
Compared with T, the PaO, OI, CL and serum SOD at T, T and T in the two groups were decreased (<0.05), and those in the observation group were higher than those in the control group (<0.05). The RI and serum levels of MDA, IL-6, TNF-α at T, T and T in the two groups were increased, and those in the observation group were lower than those in the control group (<0.05). The total incidence of complications in the observation group was lower than that in the control group [3.3% (1/30) vs 23.3% (7/30), <0.05]. The pressing times of postoperative patient-controlled analgesia pump in 48 h after surgery and hospital stay in the observation group were less than those in the control group (<0.05).
EA at Neiguan (PC 6) has protective effects on lung injury induced by OLV after lobectomy, and its mechanism may be related to the improvement of oxidative stress and inflammatory response.
观察电针内关穴（PC 6）对肺叶切除术患者单肺通气（OLV）期间肺功能的保护作用，并探讨其作用机制。
将60例肺叶切除术患者随机分为观察组和对照组，每组30例。对照组采用全身麻醉，手术开始时进行OLV；手术结束后，排出胸腔内气体并进行双肺通气。观察组在对照组治疗的基础上，于麻醉诱导前30分钟开始至手术结束，电针内关穴（PC 6）（疏密波，频率2 Hz/100 Hz）。观察手术前（T0）、OLV 30分钟时（T1）、OLV 60分钟时（T2）及术后（T3）的肺功能指标[动脉血氧分压（PaO）、氧合指数（OI）、肺顺应性（CL）、呼吸指数（RI）]以及血清超氧化物歧化酶（SOD）、丙二醛（MDA）、白细胞介素6（IL-6）和肿瘤坏死因子α（TNF-α）水平。比较两组并发症总发生率、术后48小时患者自控镇痛泵按压次数及住院时间。
与T0比较，两组T1、T2、T3时的PaO、OI、CL及血清SOD均降低（P<0.05），且观察组高于对照组（P<0.05）。两组T1、T2、T3时的RI及血清MDA、IL-6、TNF-α水平均升高，且观察组低于对照组（P<0.05）。观察组并发症总发生率低于对照组[3.3%（1/30）比23.3%（7/30），P<0.05]。观察组术后48小时患者自控镇痛泵按压次数及住院时间少于对照组（P<0.05）。
电针内关穴（PC 6）对肺叶切除术后OLV所致肺损伤具有保护作用，其机制可能与改善氧化应激和炎症反应有关。
