目的 :观察针刺复合安氟醚全麻下实施食管癌根治术的临床应用效果。方法 :采用随机单盲法观察

70名食管癌患者随机分为A、B、C三组

A组 (n =2 4)即针刺复合安氟醚麻醉组

B组 (n =2 3)即电极板穴位刺激复合安氟醚麻醉组

C组 (n =2 3)即单纯安氟醚复合麻醉组 (对照组 )。三组静脉诱导和气管插管方法相同

麻醉维持静注芬太尼和维库溴铵用量相同

对安氟醚吸入浓度则根据病人血压、心率调节

术中A、B两组同时开放电刺激仪。结果 :A、B两组麻醉效果优于C组

A、B两组麻醉Ⅰ级率分别为 6 2 5 0 %和 6 5 2 2 %

C组仅为 43 48%

显著低于A、B两组。麻醉全程安氟醚用量A、B两组分别比C组平均少用 2 9 73%和 37 84%。上述结果具有统计学差异

P <0 0 1

显示针刺与全麻两者有协同作用。结论 :针麻复合安氟醚全身麻醉下施行食管癌手术

麻醉效果肯定

方法安全、新颖

并能减少安氟醚用量

降低麻醉费用

由于针麻可调节机体功能

能使并发症减少

故可作为食管癌手术的一种麻醉方法加以推广Objective: To observe the therapeutic effect of acupuncture combined with enflurane general anesthesia (ACEGA) for esophagectomy. Methods: 70 esophageal carcinoma patients were randomly divided into ACEGA group (n=24)

electrical stimulation + enflurane general anesthesia (ES+EGA) group (n=23) and EGA control group (n=23). Xiayifeng Point and Sanyangluo (TE 8) to Ximen (PC 4) were punctured and stimulated with HANS (Apparatus) in patients of ACEGA group and only stimulated with electrical pulses in patients of ES+EGA group. Before enflurane anesthesia

all the patients accepted intramuscular injection of valium (0.1 g/50 kg) and atropine (0.5 mg/50 kg); after anesthesia

they accepted intravenous injection of fentany (2 μg/kg/hr) and vecuronium (0.03 mg/kg/0.5 hr). Results: In ACEGA

ES+EGA and EGA groups

the excellent rates of anesthesia accounted for 62.5% (15 cases)

65.22% (15 cases) and 43.48% (10 cases) respectively; the good rates were 20.83% (6 cases)

26.09% (6 cases) and 52.17% (12 cases) separately; and the poor rates were 16.67% (4 cases)

8.69% (2 cases) and 4.35% (1 case) separately. The dosages of the inhaled enflurane of ACEGA and ES+EGA were 29.73% and 37.84% lower than EGA group separately (P<0.05

P<0.01). There were significant differences between ACEGA and EGA and between ES+EGA and EGA groups in the anesthetic effect (P<0.01)

showing a synergistic action between acupuncture/acupoint electrical stimulation and enflurane. Conclusion: Acupuncture combined with unflurane general anesthesia for esophagectomy has a good effect in regulating organic functional activities and reducing complications.