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上海中医药大学附属曙光医院神经外科
纸质出版日期:2014
移动端阅览
张珏, 费智敏, 书国伟, 等. 针药复合麻醉在颅脑功能区手术中的应用[J]. 针刺研究, 2014,39(1):12-15.
ZHANG Jue, FEI Zhi-min, SHU Guo-wei, et al. Electroacupuncture Intervention Combined with General Anesthesia for Craniocerebral Operations[J]. Acupuncture research, 2014, 39(1): 12-15.
张珏, 费智敏, 书国伟, 等. 针药复合麻醉在颅脑功能区手术中的应用[J]. 针刺研究, 2014,39(1):12-15. DOI: 10.13702/j.1000-0607.2014.01.003.
ZHANG Jue, FEI Zhi-min, SHU Guo-wei, et al. Electroacupuncture Intervention Combined with General Anesthesia for Craniocerebral Operations[J]. Acupuncture research, 2014, 39(1): 12-15. DOI: 10.13702/j.1000-0607.2014.01.003.
目的:验证针药复合麻醉在颅脑功能区手术中应用的安全性、有效性。方法:20例颅脑功能区肿瘤切除手术患者随机分为2组
对照组10例患者采取气管插管静脉复合全麻手术
试验组10例患者在无气管插管的针药复合麻醉下行病灶切除术
电针风池、率谷
针刺颧髎、足临泣、太冲
诱导30min。观察患者疼痛耐受情况、麻醉药物用量、神经功能评分及安全性。结果:所有患者均成功实施肿瘤切除手术。试验组患者均成功在无气管插管的针药复合麻醉下行病灶切除术
患者能耐受术中疼痛
能配合行神经功能监测
术后均无神经功能障碍加重。试验组较对照组麻醉药物用量减少(P<0.05)
手术前后神经功能评分差值与对照组相比差异无统计学意义(P>0.05)。结论:针药复合麻醉切除脑部功能区肿瘤安全有效。术中患者能清醒配合
可最大限度保护神经功能。
Objective To determine the safety and effectiveness of electroacupuncture(EA)intervention combined with general anesthesia(GA)for craniocerebral tumor-removal surgery involving cerebral eloquent areas.Methods A total of 20patients with cerebral tumors(durosarcoma
neurogliocytoma
metastatic tumor)involving the cerebral eloquent areas were recruited in the present summary.They were equally divided into general anesthesia(GA)group and EA+GA group.Patients of the EA+GA group were treated with EA stimulation(2Hz/100Hz)of the bilateral Fengchi(GB 20)
Shuaigu(GB 8)and acupuncture stimulation of Quanliao(SI 18)
Zulinqi(GB 41)and Taichong(LR 3)
and not given intubation during surgery.Patients of the GA group were treated with intravenous administration of Propofol
Fentanyl
Midazolam
Isopropanol
etc.In addition
all the patients were given with controlled hypotension by intravenous injection of Propofol and Fentanyl.Dosages of Propofol and Sulfentanyl used were recorded.Karnofsky performance status scale was used to assess the patient's general well-being and activities of daily life.Results The craniocerebral tumor-removal surgery was successful in all the 20patients.Compared with the GA group
the dosages of Sulfentanyl and Propofol of the EA+GA group were significantly lower(P<0.05).No significant difference was found between the GA and EA+GA groups in Karnofsky performance scores(P>0.05).Patients of the EA+GA group experienced successful tumour-removal surgery without trachea cannula
were awake and could make a good cooperation with the operator during surgery.They had no aggravation of neurofunctional disturbance following the operation.Conclusion EA combined with general anesthesia is safe and effective for patients with craniocerebral tumor-removal operations involving cerebral eloquent areas.
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