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电针预处理联合α2AR激动剂对围手术期心率变异性的影响

陈轶菁 沈华 周正清 陈谦 陈磊 赵小敏 陈潇毅 朱俊 陈云飞

上海针灸杂志2017,Vol.36Issue(5):541-545,5.
上海针灸杂志2017,Vol.36Issue(5):541-545,5.DOI:10.13460/j.issn.1005-0957.2017.05.0541

电针预处理联合α2AR激动剂对围手术期心率变异性的影响

Effect of Pre-intervention with Electroacupuncture at Neiguan (PC 6) plus Intra-operative Administration ofα2-adrenoceptor Agonist on Peri-operative Heart Rate Variability

陈轶菁 1沈华 1周正清 1陈谦 1陈磊 1赵小敏 1陈潇毅 1朱俊 1陈云飞1

作者信息

  • 1. 上海中医药大学附属岳阳中西医结合医院,上海 200437
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摘要

Abstract

Objective To observe the effect of pre-intervention with electroacupuncture at Neiguan (PC 6) plusα2-adrenoceptor (α2AR) agonist on peri-operative heart rate variability (HRV).Method A total of 120 patients going to receive lower limb orthopedic surgery were randomized into four groups by using the random number table, namely a control group (group A), an electroacupuncture group (group C), anα2AR agonist group (group D) and an electroacupuncture plus medication group (group N), 30 cases in each group. The indicators of heart rate variability (HRV), including the standard deviation of normal-to-normal (N-N) intervals (SDNN), standard deviation of the average of N-N intervals (SDANN), root mean square successive differences (rMSSD), percentage of adjacent N-N intervals>50 ms apart (pNN50), low-frequency power (LF), high-frequency power (HF), LF/HF and total power (TP) were recorded 1 d prior and 1 d after the operation; meanwhile, the mean arterial pressure (MAP) and heart rate (HR) were recorded before incubation (T0), right after incubation (T1), 5 min after incubation (T2), right afterextubation (T3), 5 min after extubation (T4), 60 min after extubation (T5), and 180 after extubation (T6).Result In group N, the HR and MAP at the other time points were insignificantly different from those at T0 (P>0.05); in group A, the HR and MAP at T1-T6 were significantly different from those at T0 (P<0.05); in group C and D, the HR and MAP at T1-T4 were significantly different from those at T0 (P<0.05); the HR and MAP in group N were significantly lower than those in group A at T1-T6 (P<0.05) and were significantly lower than those in group C and D at T1-T4 (P<0.05); the HR and MAP in group C and D were significantly lower than those in group A at T5 and T6 (P<0.05). In group A, the LF, HF, LF/HF and TP 1 d after the operation were significantly increased compared to those 1 d prior to the operation (P<0.05); in group A and D, the SDNN, SDANN, rMSSD, and pNN501 d after the operation were significantly lower than those 1 d prior to the operation (P<0.05); the LF, HF, LF/HF, and TP in group C, D and N were significantly lower than those in group A 1 d after the operation (P<0.05); the SDNN, SDANN, rMSSD, and pNN50 in group C and N were significantly higher than those in group A and D 1 d after the operation (P<0.05). Conclusion Pre-intervention electroacupuncture plusα2AR agonist can improve the balance of cardiac sympathetic and vagus nerves, and better maintain the peri-operative hemodynamic stability.

关键词

电针/围手术期/α2AR激动剂/心率变异性/平均动脉压/心率

Key words

Electroacupuncture/Point/Neiguan (PC 6)/Peri-operation/α2AR agonist/Heart rate variability/Mean arterial pressure/Heart rate

分类

医药卫生

引用本文复制引用

陈轶菁,沈华,周正清,陈谦,陈磊,赵小敏,陈潇毅,朱俊,陈云飞..电针预处理联合α2AR激动剂对围手术期心率变异性的影响[J].上海针灸杂志,2017,36(5):541-545,5.

基金项目

上海市卫生局科教处(30304113471) (30304113471)

上海针灸杂志

OACSTPCD

1005-0957

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