上海针灸杂志2025，Vol.44Issue(6)：716-722,7.DOI:10.13460/j.issn.1005-0957.2024.13.4030
醒脑开窍针刺法对老年患者全髋置换术后苏醒质量的影响
Effect of Xing Nao Kai Qiao acupuncture on the quality of recovery after total hip replacement in aged patients
摘要
Abstract
Objective To observe the effect of Xing Nao Kai Qiao(brain-awakening and orifice-opening)acupuncture on the quality of recovery and delirium after total hip replacement(THR)under general anesthesia in aged patients.Method Eighty-four senile patients who were going to receive THR were randomized into an observation group and a control group,with 42 cases in each group.The observation group received Xing Nao Kai Qiao acupuncture 30 min before anesthesia induction and when the surgery finished;the control group was intervened by sham acupuncture.The operative duration,intraoperative blood loss,infusion volume,and emergence time,as well as the Steward and Aldrete scores 10 min and 30 min after extubation,were compared between the two groups.Before anesthesia induction,after extubation,and on postoperative day 3,the serum levels of noradrenaline(NA),C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),neuron-specific enolase(NSE),microtubule-associated protein Tau,neurofilament light chain protein(NfL),and central nervous system specific protein β(S100β)and the incidence of postoperative delirium(POD)were compared.The incidence of adverse reactions was also compared between the two groups.Result The serum levels of NA,CRP,IL-6,and TNF-α increased significantly after extubation and on postoperative day 1 in both groups compared to the levels before anesthesia induction(P＜0.05).The serum contents of NSE,NfL,and S100β rose significantly on postoperative day 1 and day 3 compared to 1 day before the operation(P＜0.05).Compared to the control group,the emergence time was shorter in the observation group,along with a higher Aldrete score 10 min after extubation,a higher Steward score 30 min after extubation,lower serum NA,IL-6,and TNF-α contents on postoperative day 1,lower NSE,Tau,and NfL contents on postoperative day 3,a lower POD incidence on postoperative days 1 and 3,and a lower postoperative rate of nausea and vomiting,all presenting statistical significance(P＜0.05).The between-group differences in the extubation time,Steward score 10 min after extubation,Aldrete score 30 min after extubation,incidence of POD on postoperative day 7,and adverse reaction rate were statistically insignificant(P＞0.05).Conclusion Xing Nao Kai Qiao acupuncture can improve the quality of recovery,reduce perioperative stress and inflammatory reactions,and lower the incidence of POD after THR in aged patients.关键词
针刺疗法/醒脑开窍/全髋关节置换术/术后/苏醒/谵妄Key words
Acupuncture therapy/Xing Nao Kai Qiao/Total hip replacement/Postoperative/Recovery/Delirium分类
医药卫生引用本文复制引用
王静,张建楠,支平,蔡靓羽,李荣华..醒脑开窍针刺法对老年患者全髋置换术后苏醒质量的影响[J].上海针灸杂志,2025,44(6):716-722,7.基金项目
江苏省中医药管理局科技项目(MS2022057) （MS2022057）
无锡市卫生健康委科研项目(Q202260) （Q202260）
南京中医药大学自然科学基金项目(XZR2023025) （XZR2023025）
