针药复合麻醉在颅脑功能区手术中的应用.pdf

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1、·12·AcupunctureResearch，Feb．2014，Vo1．39，No．1针药复合麻醉在颅脑功能区手术中的应用张珏费智敏书国伟蔡佩浩王静予许乐宜孔令军邱锋龚立陈丽顾国山(上海中医药大学附属曙光医院神经外科，上海201203)【摘要】目的：验证针药复合麻醉在颅脑功能区手术中应用的安全性、有效性。方法：20例颅脑功能区肿瘤切除手术患者随机分为2组，对照组1O例患者采取气管插管静脉复合全麻手术，试验组1O例患者在无气管插管的针药复合麻醉下行病灶切除术，电针风池、率谷，针刺颧醪、足临泣、太冲，诱导30rai

2、n。观察患者疼痛耐受情况、麻醉药物用量、神经功能评分及安全性。结果：所有患者均成功实施肿瘤切除手术。试验组患者均成功在无气管插管的针药复合麻醉下行病灶切除术，患者能耐受术中疼痛，能配合行神经功能监测，术后均无神经功能障碍加重。试验组较对照组麻醉药物用量减少(P<0．05)，手术前后神经功能评分差值与对照组相比差异无统计学意义(P>0．05)。结论：针药复合麻醉切除脑部功能区肿瘤安全有效。术中患者能清醒配合，可最大限度保护神经功能。【关键词】针刺辅助全麻颅脑肿瘤切除手术颅脑功能区无气管插管【中图分类号】R246．2

3、【文献标志码】B【文章编号】1000—0607(2014)01—0012—04Electr0acupunctureInterventionCombinedwithGeneralAnesthesiaforCrani0cerebralOpera。tionsZHANGJue，FEIZhi—rain，SHUGuo—wei，CAIPei—hao，WANGJing—yu，XULe-yi，KONGLing—jun，QIUFeng，GONGLi，CHENLi，GUGuo—shan(DepartmentofNeurosurgery

4、，ShuguangHospitalAffiliatedtoShanghaiUniversitYo厂TraditionalChineseMedicine，Shanghai201203，China)[ABSTRACT]0bjectiveTodeterminethesafetyandefectivenessofelectroacupuncture(EA)interventioncombinedwithgeneralanesthesia(GA)forcraniocerebraltumor．removalsurgeryin

5、volvingcerebraleloquentareas．MethodsAtotalof20patientswithcerebraltumors(durosarcoma，neurogliocytoma，metastatictumor)involvingthecerebraleloquentareaswerere—cruitedinthepresentsummary．Theywereequallydividedintogeneralanesthesia(GA)groupandEA+GAgroup．Patientso

6、ftheEA+GAgroupweretreatedwithEAstimulation(2Hz／100Hz)ofthebilateralFengchi(GB20)，Shuaigu(GB8)andacupuncturestimulationofQuanliao(SI18)，Zulinqi(GB41)andTaichong(LR3)，andnotgivenintubationduringsurgery．PatientsoftheGAgroupweretreatedwithintravenousadministratio

7、nofPropofol，Fentanyl，Midazolam，Isopropanol，etc．Inaddition，allthepa·tientsweregivenwithcontrolledhypotensionbyintravenousinjectionofPropofolandFentany1．DosagesofPropofoIandSulfenta—nylusedwererecorded．Karnofskyperformancestatusscalewasusedtoassessthepatient’sg

8、eneralwell—beingandactivitiesofdailylifeResultsThecraniocerebraltumor．removalsurgerywassuccessfulinallthe20patients．ComparedwiththeGAgroup，thedosagesofSulfentanylandPropofoloftheEA十GAgrou