【摘要】 目的 观察全髋关节置换术术后针刺“醒神通络六穴”(百会、神门、合谷、内关、足三里、三阴交)对早期认知障碍的改善情况。方法 对60例老年患者在全麻下行全髋关节置换术(ASA分级Ⅰ-Ⅲ级)。随机分为针刺组与对照组，每组30例。针刺组在术后连续14 d给予针刺百会、神门、合谷、内关、足三里、三阴交六穴位。对照组未对患者行针刺治疗。统计两组患者一般情况、手术时长、出血量，并于术前1天，术后第1、5、14天记录两组患者疼痛评分(VAS),认知功能评分(FAQ),精神状态评分(MMSE)等认知功能指标，进行统计学分析。结果 术后第5天，与对照组比较，针刺组的VAS评分、MMSE评分、FAQ评分均有改善(P<0.05),其中VAS评分明显降低。而术后第1天和第14天，两组的VAS评分、MMSE评分、FAQ评分差异无统计学意义。结论 全髋关节置换术术后对全麻患者给予电针针刺百会、神门、合谷、内关、足三里、三阴交，可显著改善术后认知障碍，为早期下地行走，恢复髋部行走功能积极创造有利条件。更多还原

【Abstract】 Objective To observe the improvement of early cognitive impairment after total hip arthroplasty by acupuncture at inducing resuscitation six acupuncture points(Baihui, Shenmen, Hegu, Neiguan, Zusanli, and Sanyinjiao).Methods Sixty elderly patients undergoing total hip arthroplasty under general anesthesia(ASA grading I to III) were randomly divided into the control group and the acupuncture group, with 30 cases in each group. The acupuncture group received acupuncture at Baihui, Shenmen, Hegu, Neiguan, Zusanli, and Sanyinjiao, on the day for 14 consecutive days after the surgery, while the control group did not receive the acupuncture treatment. The general situation, duration of surgery and amount of blood loss of patients in the two groups were analyzed, the cognitive function indexes such as pain score(VAS), cognitive function score(FAQ) and mental state score(MMSE) of patients in the two groups were observed 1 day before the surgery and 1, 5 and 14 days after the surgery, and statistical analysis was conducted.Results On the 5 th day after the surgery, compared with those of the control group, VAS score, MMSE score and FAQ score of the acupuncture group improved(P<0.05), and VAS score significantly decreased. On the 1 st and 14 th day after the surgery, there were no significant differences in VAS score, MMSE score and FAQ score between the two groups.Conclusion Postoperative electro acupuncture at Baihui, Shenmen, Hegu, Neiguan, Zusanli, and Sanyinjiao in patients with general anesthesia after total hip replacement can significantly improve the postoperative cognitive impairment, and has a positive effect on early ambulation and other functional exercises of hips.更多还原