目的 :通过测定针刺 (或穴位电极刺激 )复合小剂量硬膜外麻醉胆囊切除术血糖含量的变化

推测针刺复合麻醉具有调整交感神经功能

减轻手术应激反应的作用。方法 :胆囊切除术共46例

其中A组 (针硬组 ) 1 6例

B组 (电硬组 ) 1 4例

C组 (对照组 ) 1 6例。每例于术前 1天

术中3 0min、术后 3天分别抽外周静脉血测定血糖含量。结果 :A、B两组血糖值术中比术前略升高

组内比较无显著差异 (P >0 .0 5)。C组 (对照组 )血糖值术中比术前升高明显

组内比较有极显著差异 (P <0 .0 1 )。A、B两组与C组术中血糖值比较有极显著差异 (P <0 .0 1 )。结论 :A组 (针硬组 )或B组 (电硬组 )在复合硬膜外麻醉中具有调整交感神经功能

减轻手术应激反应

使术中、术后血糖稳定等优点Objective: To observe the effect of acupuncture combined with extradural administration of anesthetic on blood sugar level in patients experiencing cholecystectomy for evaluating the regulative effect of acupuncture on sympathetic nerve activity. Methods: 46 cases of cholecystectomy patients were randomly divided into group A (n=16

electroacupuncture combined with extradural administration of small dose of analgesic-1.5% Lidocaine

etc.) and group B (n=14

transcutaneous electrical stimulation combined with extradural administration of small dose of analgesic) and control group (n=16

simple epidural administration of analgesic). In group A and B

bilateral Neiguan (PC 6) and Zusanli (ST 36) were used for EA (2/15 Hz

2～3 mA) and transcutaneous electrical nerve stimulation (2/ 15 Hz

13 mA). Blood sugar contents were determined 1 day before operation

during operation (30 minutes after anesthesia) and 3 days after operation in all the cases. Results: Results displayed that in group A and B

patients with excellent analgesic effects were found in 11 (68.8%) and 6 (42.9%) cases

with good analgesic effect found in 5 (31.2%) and 7 (50.0%) cases

and with poor analgesic effect in 0 and 1 (7.1%) case respectively. While in control group

those with good analgesic effect were found in 2 (12.5%) cases

with poor analgesic effect found in 12 (75.0%) cases

and 2 (12.5%) cases failed in the anesthetic effect. There were no significant changes of blood sugar levels in group A and B during and after operation in comparison with pre-operation

while in group C

blood sugar levels increased evidently during and after operation (P<0.01). Comparison among the 3 groups showed that during operation

blood sugar levels of group A and B were markedly lower than that of control group (P<0.01). Conclusion: Electroacupuncture or transcutaneous electrical nerve stimulation combined with extradural administration of small dose of analgesic has a good analgesic effect

and stabilize blood sugar level that may be closely associated with acupoint-stimulation induced decrease of sympathetic activity and stress response during operation.