【摘要】 目的 :探讨针刺腧穴对开颅术中患者脑组织氧分压 (PbtO2 )、二氧化碳分压 (PbtCO2 )和 pH值的影响及临床意义。方法 :对 2 0例在全麻下行开颅术患者术中持续进行脑组织氧代谢监测 ,针刺涌泉、厉兑 1 0分钟 ,比较针刺前 5分钟、针刺 1 0分钟、针刺停止后 5分钟PbtO2 、PbtCO2 、pH值、心率 (HR)和平均动脉压 (MAP)的变化。结果 :PbtO2 、PbtCO2 和 pH值在针刺中和针刺停止后 5分钟内与针刺前比较差异均有显著性意义 (P <0 0 5 ) ,HR和MAP在针刺中增加 ,针刺停止后回到针刺前水平。结论 :针刺腧穴可增加PbtO2 和 pH值 ,降低PbtCO2 ,即能增加脑血流量 ,改善脑组织微循环和脑组织氧代谢 ,对脑组织起保护作用。脑组织氧代谢监测仪所测参数能直接动态反映脑组织的病理生理变化 ,及时发现脑组织缺血缺氧 ,对指导开颅术中的脑保护治疗有重要意义更多还原

【Abstract】 Objective To investigate the clinical effect of acupuncture on partial pressure of oxygen (PO 2) and carbon dioxide (PCO 2) and pH value in brain tissue of the patient during craniotomy. Methods Oxygen metabolism of brain tissue in 20 patients underwent craniotomy with general anesthesia were monitored continuously by a neurotrend multi parameter monitoring instrument. Acupuncture was given on Yongquan (KI 1) and Lidui (ST 45) for 10 min, and PO 2, PCO 2, pH value, heart rate (HR) and mean arterial pressure (MAP) 5 min before acupuncture (baseline), 10 min after acupuncture and 5 min after ceasing acupuncture were determined. Results The PO 2, PCO 2 and pH value during acupuncture and after ceasing acupuncture were significantly different from the baseline ( P <0 05); and HR and MAP increased during acupuncture and they returned to the baseline after ceasing acupuncture. Conclusion Acupuncture can increase PO 2 and pH value and decrease PCO 2 in the brain tissue, which indicate that acupuncture can raise cerebral blood flow, improve cerebral microcirculation and oxygen metabolism in the brain tissue, protecting brain tissue. And the indexes determined by the monitoring instrument can directly and dynamically reflect pathophysiological changes of the brain tissue and discover ischemia and anoxia of the brain tissue in time, which is of important significance for protective treatment of brain during craniotomy.更多还原