【摘要】 目的 观察骶管麻醉联合经皮穴位电刺激对混合痔麻醉效果及血清β-内啡肽和皮质醇水平的影响。方法 选择100例混合痔患者随机分为观察组和对照组,每组50例。观察组以经皮穴位电刺激辅助骶管麻醉,对照组予以单纯骶管麻醉。观察两组围手术期心率(HR)、收缩压(SBP)、舒张压(DBP)、视觉模拟量表(VAS)评分、血清β-内啡肽和皮质醇水平的变化,并比较两组麻醉效果和并发症发生率情况。结果 观察组HR水平在T3～T4时间点明显低于对照组(P<0.01),SBP和DBP水平在T2时间点明显低于对照组(P<0.01);其他时间点两组HR、SBP和DBP水平比较,差异无统计学意义(P>0.05)。两组在T0时间点VAS、β-内啡肽和皮质醇水平比较,差异无统计学意义(P>0.05),观察组在T1～T4时间点VAS评分和皮质醇水平明显优于对照组(P<0.01),而观察组在T1、T3～T4时间点β-内啡肽明显高于对照组(P<0.01)。观察组的肛门松弛度、舒适度和牵拉反射评分明显低于对照组(P<0.01);两组麻醉起效时间、痛觉恢复时间和下肢运动阻滞恢复时间比较,差异无统计学意义(P>0.05)。观察组恶心、呕吐和尿潴留发生率明显低于对照组(P<0.05),两组穿刺点渗血和腰痛发生率比较,差异无统计学意义(P>0.05)。结论 骶管麻醉联合经皮穴位电刺激对混合痔麻醉效果确切,能够明显降低术中疼痛,提高术中肛门松弛度、舒适度,降低并发症的发生。更多还原

【Abstract】 Objective To observe the anesthesia effect of causal anesthesia plus transcutaneous electrical acupoint stimulation(TEAS) for mixed hemorrhoids and its effects on the levels of serum β-endorphin(β-EP) and cortisol.Method One hundred patients with mixed hemorrhoids were randomly divided into an observation group and a control group, with 50 cases in each group. The observation group was given TEAS to assist caudal anesthesia, and the control group only received caudal anesthesia. The peri-operative heart rate(HR), systolic blood pressure(SBP),diastolic blood pressure(DBP), visual analog scale(VAS) score, and the levels of serumβ-EP and cortisol were observed for the two groups. The anesthesia effect and incidence of complications were also compared. Result The HR was notably lower in the observation group than in the control group at T3-T4(P<0.01), and the SBP and DBP were significantly lower in the observation group than in the control group at T2(P<0.01). There were no significant differences in the HR, SBP, or DBP between the two groups at the other time points(P>0.05). At T0, there were no significant differences in the VAS score or the levels of β-EP and cortisol between the two groups(P>0.05). The VAS score and the level of cortisol were markedly superior in the observation group than in the control group at T1-T4(P<0.01), and the level of β-EP was notably higher in the observation group than in the control group at T1, T3-T4(P<0.01). The anal relaxation, comfort, and traction reflex scores were significantly lower in the observation group than in the control group(P<0.01). There were no significant differences in the set-in time of anesthesia, the time regaining pain sensation, or lower-limb motor blocking recovery time between the two groups(P>0.05).The incidence rates of nausea, vomiting and urinary retention were notably lower in the observation group than in the control group(P<0.05). There were no significant differences in the incidence rates of bleeding at the puncture site or low back pain between the two groups(P>0.05). Conclusion Caudal anesthesia combined with TEAS is effective for anesthesia for mixed hemorrhoids. It can reduce pain during the operation, increase the anal relaxation and comfort degrees during the operation, and reduce the incidence of complications.更多还原