Volume 21 Issue 2
Feb.  2023
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(2): 242-246
LI Ya-nan, WAN Zheng-zuo, LI Yan-yan, JUE Bin, YU Xue-lai, WANG Li-feng. Application effect of acupoint electrical stimulation combined with general anesthesia in elderly patients undergoing laparoscopic radical resection of colorectal cancer[J]. Chinese Journal of General Practice, 2023, 21(2): 242-246. doi: 10.16766/j.cnki.issn.1674-4152.002855
Citation: LI Ya-nan, WAN Zheng-zuo, LI Yan-yan, JUE Bin, YU Xue-lai, WANG Li-feng. Application effect of acupoint electrical stimulation combined with general anesthesia in elderly patients undergoing laparoscopic radical resection of colorectal cancer[J]. Chinese Journal of General Practice, 2023, 21(2): 242-246. doi: 10.16766/j.cnki.issn.1674-4152.002855
shu

Application effect of acupoint electrical stimulation combined with general anesthesia in elderly patients undergoing laparoscopic radical resection of colorectal cancer

doi: 10.16766/j.cnki.issn.1674-4152.002855

  • Anesthesiology Department, Hangzhou Hospital of Traditional Chinese Medical, Hangzhou, Zhejiang 321000, China

Funds:

 20181228Y29

 2020ZB155

 20201203B202

  • Received Date: 2022-08-29
    Available Online: 2023-04-20
    Abstract
  •   Objective  To analyze the effects of transcutaneous electrical acupoint stimulation (TEAS) combined with general anesthesia on gastrointestinal hormones and postoperative cognitive dysfunction (POCD), and investigate the effect of TEAS combined with general anesthesia in elderly patients after laparoscopic radical resection of colorectal cancer.  Methods  A total of 90 elderly patients who underwent laparoscopic radical resection of colorectal cancer in Hangzhou Hospital of Traditional Chinese Medical from January 2020 to January 2022 were selected and divided into A and B group by random number table method, with 45 cases in each group. Patients in the group A were given general anesthesia treatment, and patients in the group B were given TEAS on the basis of the group A. The perioperative indicators, hemodynamic changes at different time during operation, gastrointestinal hormone levels, central nervous specific (S100β) protein and brain derived neurotrophic factor (BDNF) levels, mini-mental state examination (MMSE) scores, and the occurrence of POCD were compared between the two groups.  Results  The dosage of propofol and remifentanil, awakening time and extubation time of the group B were significantly lower than those in the group A (P < 0.05). The level of central venous pressure (CVP) in the group B was significantly higher than that in the group A (P < 0.05). The levels of gastrin (GAS) and motilin (MTL) in both groups were significantly lower than those before surgery (P < 0.05), and the group B was significantly higher than the group A (all P < 0.05). The S100β level protein was firstly increased and then decreased (P < 0.05), and BDNF level and MMSE score were firstly decreased and then increased (all P < 0.05). The levels of S100β protein in the group B were lower than those in the group A on 1 d, 3 d and 7 d after surgery (all P < 0.05), the levels of BDNF and MMSE score were higher than those in the group A (all P < 0.05). The occurrence of POCD in the group B on 1 d and 3 d after surgery were significantly lower than those in the group A (37.78% vs. 68.89%, 24.44% vs. 51.11%, all P < 0.05).  Conclusion  TEAS combined with general anesthesia can alleviate the inhibitory effect of surgery and anesthesia on gastrointestinal hormone secretion, protect the central nervous system, improve cognitive function, and reduce the occurrence of POCD in elderly patients after laparoscopic radical colorectal cancer surgery.

     

    • FullText(HTML)
  • loading
    • References(26)
  • [1]
    陈万青, 李霓, 兰平, 等. 中国结直肠癌筛查与早诊早治指南(2020, 北京)[J]. 中国肿瘤, 2021, 30(1): 1-28. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHLU202101001.htm

    CHEN W Q, LI N, LAN P, et al. China guideline for the screening, early detection and early treatment of colorectal cancer (2020, Beijing)[J]. China Cancer, 2021, 30(1): 1-28. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHLU202101001.htm
    [2]
    中华人民共和国国家卫生健康委员会医政医管局, 中华医学会肿瘤学分会. 中国结直肠癌诊疗规范(2020年版)[J]. 中国实用外科杂志, 2020, 40(6): 601-625. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWK202006001.htm

    Medical Administration Bureau of National Health Commission of the People's Republic of China, Oncology Society of the Chinese Medical Association. Chinese protocol of diagnosis and treatment of colorectal cancer (2020 edition)[J]. Chinese Journal of Practical Surgery, 2020, 40(6): 601-625. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWK202006001.htm
    [3]
    邹雨恒, 廖伟豪, 刘莹, 等. 结直肠癌患者年龄对长期生存预后可能有影响: 基于DACCA数据库的真实世界分析[J]. 中国普外基础与临床杂志, 2022, 29(6): 795-802. https://www.cnki.com.cn/Article/CJFDTOTAL-ZPWL202206014.htm

    ZOU Y H, LIAO W H, LIU Y, et al. The age of colorectal patients may impact on long-term survival: a real-world study based on DACCA database[J]. Chinese Journal of Bases and Clinics In General Surgery, 2022, 29(6): 795-802. https://www.cnki.com.cn/Article/CJFDTOTAL-ZPWL202206014.htm
    [4]
    MCCLEARY N J, ZHANG S, MA C, et al. Age and comorbidity association with survival outcomes in metastatic colorectal cancer: CALGB 80405 analysis[J]. J Geriatr Oncol, 2022, 13(4): 469-479. doi: 10.1016/j.jgo.2022.01.006
    [5]
    李颖, 张铁峰, 蒋海斌, 等. 肺保护性通气用于老年腹腔镜结直肠癌手术患者的临床观察[J]. 中华全科医学, 2019, 17(10): 1673-1677. doi: 10.16766/j.cnki.issn.1674-4152.001026

    LI Y, ZHANG T F, JIANG H B, et al. Clinical observation of lung protective ventilation in elderly patients undergoing laparoscopic colorectal cancer surgery[J]. Chinese Journal of General Practice, 2019, 17(10): 1673-1677. doi: 10.16766/j.cnki.issn.1674-4152.001026
    [6]
    叶梦霞, 田刚. 围术期神经认知障碍危险因素与防治的研究进展[J]. 河北医药, 2021, 43(19): 3006-3011. doi: 10.3969/j.issn.1002-7386.2021.19.032

    YE M X, TIAN G. Research progress on risk factors and prevention of perioperative neurocognitive disorders[J]. Hebei Medical Journal, 2021, 43(19): 3006-3011. doi: 10.3969/j.issn.1002-7386.2021.19.032
    [7]
    魏林志, 曲宁, 管永明. 穴位电刺激对腹腔镜胆囊切除术后恶心呕吐(PONV)的干预作用[J]. 新疆医科大学学报, 2022, 45(3): 339-344. https://www.cnki.com.cn/Article/CJFDTOTAL-XJYY202203020.htm

    WEI L Z, QU N, GUAN Y M. Intervention effect on acupoint electrical stimulation of postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy[J]. Journal of Xinjiang Medical University, 2022, 45(3): 339-344. https://www.cnki.com.cn/Article/CJFDTOTAL-XJYY202203020.htm
    [8]
    孔昊, 张鸿. 术中伤害性刺激及镇痛水平监测的研究进展[J]. 临床麻醉学杂志, 2020, 36(6): 612-615. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ202006027.htm

    KONG H, ZHANG H. Research progress in monitoring injurious stimulation and analgesic level during operation[J]. Journal of Clinical Anesthesiology, 2020, 36(6): 612-615. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ202006027.htm
    [9]
    邓达玲, 赵帅, 陈向东. 全身麻醉药物对睡眠影响的研究进展[J]. 临床麻醉学杂志, 2022, 38(2): 199-202. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ202202018.htm

    DENG D L, ZHAO S, CHEN X D. Progress in mechanisms of effects on sleep by general anesthetics[J]. Journal of Clinical Anesthesiology, 2022, 38(2): 199-202. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ202202018.htm
    [10]
    王秀丽, 余剑波, 李文志, 等. 穴位刺激围术期应用专家共识[J]. 中华麻醉学杂志, 2017, 37(10): 1153-1158.

    WANG X L, YU J B, LI W Z, et al. Consensus on perioperative application of acupoint stimulation[J]. Chinese Journal of Anesthesilolgy, 2017, 37(10): 1153-1158.
    [11]
    中国医师协会外科医师分会, 中华医学会外科分会胃肠外科学组, 中华医学会外科分会结直肠外科学组, 等. 中国结直肠癌肝转移诊断和综合治疗指南(2020版)[J]. 临床肝胆病杂志, 2021, 37(3): 543-553. https://www.cnki.com.cn/Article/CJFDTOTAL-LCGD202103011.htm

    Chinese College of Surgeons of Chinese Medical Doctor Association, Chinese Society Gastrointestinal Surgery of Chinese Society of Surgery of Chinese Medical Association, Chinese Society of Colorectal Surgery of Chinese Society of Surgery of Chinese Medical Association, et al. China guideline for diagnosis and comprehensive treatment of colorectal liver metastases(2020 edition)[J]. Journal of Clinical Hepatology, 2021, 37(3): 543-553. https://www.cnki.com.cn/Article/CJFDTOTAL-LCGD202103011.htm
    [12]
    吕艳, 张增强, 王海, 等. 海南版简易智能状态检查量表和蒙特利尔认知评估量表界值划分的初步研究[J]. 中华老年心脑血管病杂志, 2020, 22(4): 352-355. https://www.cnki.com.cn/Article/CJFDTOTAL-LNXG202004007.htm

    LYU Y, ZHANG Z Q, WANG H, et al. Cut-off point of Chinese Hainan version of MMSE scale and MoCA scale[J]. Chinese Journal of Geriatric Heart Brain and Vessel Diseases, 2020, 22(4): 352-355. https://www.cnki.com.cn/Article/CJFDTOTAL-LNXG202004007.htm
    [13]
    唐毅, 李玉娟, 陈亚, 等. 经皮穴位电刺激联合全身麻醉对腹腔镜结直肠癌根治术患者炎性因子、T细胞亚群和认知功能的影响[J]. 现代生物医学进展, 2020, 20(23): 4571-4575. https://www.cnki.com.cn/Article/CJFDTOTAL-SWCX202023037.htm

    TANG Y, LI Y J, CHEN Y, et al. Effects of transcutaneous acupoint electrical stimulation combined with general anesthesia on inflammatory factors, t cell subsets and cognitive function in patients undergoing laparoscopic radical resection of colorectal cancer[J]. Progress in Modern Biomedicine, 2020, 20(23): 4571-4575. https://www.cnki.com.cn/Article/CJFDTOTAL-SWCX202023037.htm
    [14]
    张晓, 余先昊. 腹腔镜结直肠癌根治术对老年结直肠癌患者术后胃肠功能恢复的影响[J]. 中国老年学杂志, 2021, 41(11): 2283-2286. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ202111015.htm

    ZHANG X, YU X H. Effect of laparoscopic colorectal resection on gastrointestinal function recovery of elderly patients with colorectal cancer[J]. Chinese Journal of Gerontology, 2021, 41(11): 2283-2286. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ202111015.htm
    [15]
    WESTRICH G, VENTURERO M, SCHTRECHMAN G, et al. Transanal minimally invasive surgery for benign and malignant rectal lesions: operative and oncological outcomes of a single center experience[J]. J Laparoendosc Adv Surg Tech A, 2019, 29(9): 1122-1127.
    [16]
    XU Q W, XU P Y, CEN Y Y, et al. Effects of preoperative oral administration of glucose solution combined with postoperative probiotics on inflammation and intestinal barrier function in patients after colorectal cancer surgery[J]. Oncol Lett, 2019, 18(1): 694-698.
    [17]
    黄枭, 张菊霞, 罗婷, 等. 经皮穴位电刺激对不停跳冠状动脉搭桥术患者术后神经认知功能的影响[J]. 临床麻醉学杂志, 2020, 36(9): 861-865. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ202009007.htm

    HUANG X, ZHANG J X, LUO T, et al. Effect of transcutaneous electrical acupoint stimulationon on postoperative neurocognitive disorders in patients undergoing off-pump coronary artery bypass grafting[J]. Journal of Clinical Anesthesiology, 2020, 36(9): 861-865. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ202009007.htm
    [18]
    中国中西医结合学会麻醉专业委员会. 穴位刺激防治术后恶心呕吐专家指导意见[J]. 临床麻醉学杂志, 2019, 35(6): 596-599. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201906022.htm

    Anesthesia Professional Committee of Chinese Association of Integrated Traditional Chinese and Western Medicine. Expert guidance on acupoint stimulation for prevention and treatment of postoperative nausea and vomiting[J]. Journal of Clinical Anesthesiology, 2019, 35(6): 596-599. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201906022.htm
    [19]
    战海燕, 周琪, 张析哲, 等. 经皮穴位电刺激对腹腔镜腹股沟疝修补术患儿术后行为改变的影响[J]. 临床麻醉学杂志, 2020, 36(4): 330-333. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ202004004.htm

    ZHAN H Y, ZHOU Q, ZHANG X Z, et al. Effect of percutaneous acupoint electrical stimulation on postoperative maladaptive behavior in children undergoing laparoscopic inguinal hernia repair[J]. Journal of Clinical Anesthesiology, 2020, 36(4): 330-333. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ202004004.htm
    [20]
    张可, 张圆, 余剑波. 经皮穴位电刺激对腹腔镜非胃肠手术患者术后胃肠功能的影响[J]. 中华麻醉学杂志, 2020, 40(8): 911-914. https://cdmd.cnki.com.cn/Article/CDMD-10368-1021008200.htm

    ZHANG K, ZHANG Y, YU J B. Effect of transcutaneous electrical acupoint stimulation on postoperative gastrointestinal function in patients undergoing laparoscopic non-gastrointestinal surgery[J]. Chinese Journal of Anesthesiology, 2020, 40(8): 911-914. https://cdmd.cnki.com.cn/Article/CDMD-10368-1021008200.htm
    [21]
    常明智, 隆巧玉, 林瞬艳, 等. 经皮穴位电刺激对睡眠障碍老年患者全髋关节置换术后疲劳及谵妄的影响[J]. 临床麻醉学杂志, 2021, 37(10): 1013-1017. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ202110001.htm

    CHANG M Z, LONG Q Y, LIN S Y, et al. Effect of transcutaneous electrical acupoint stimulation on postoperative fatigue and delirium in elderly patients with sleep disorder undergoing total hip arthroplasty[J]. Journal of Clinical Anesthesiology, 2021, 37(10): 1013-1017. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ202110001.htm
    [22]
    魏来, 罗雯, 黄俊, 等. 经皮穴位电刺激神门穴、内关穴对老年髋关节置换术患者睡眠质量及术后谵妄的影响[J]. 国际麻醉学与复苏杂志, 2021, 42(10): 1056-1060. https://cdmd.cnki.com.cn/Article/CDMD-10542-1020319921.htm

    WEI L, LUO W, HUANG J, et al. The effect of transcutaneous electrical acupoint stimulation of Shenmen and Neiguan points on sleep quality and postoperative delirium in elderly patients undergoing hip replacement[J]. International Journal of Anesthesiology and Resuscitation, 2021, 42(10): 1056-1060. https://cdmd.cnki.com.cn/Article/CDMD-10542-1020319921.htm
    [23]
    黄彦逵, 刘慧慧. 穴位电刺激辅助麻醉对腔镜直肠癌手术患者胃肠激素及免疫功能影响[J]. 新疆医科大学学报, 2019, 42(12): 1630-1634. https://www.cnki.com.cn/Article/CJFDTOTAL-XJYY201912026.htm

    HUANG Y K, LIU H H. Effect of transcutaneous electrical acupoint stimulation-assisted general anesthesia on gastrointestinal hormones and immune function in patients undergone laparoscopic colorectal surgery[J]. Journal of Xinjiang Medical University, 2019, 42(12): 1630-1634. https://www.cnki.com.cn/Article/CJFDTOTAL-XJYY201912026.htm
    [24]
    FENG B, ZHANG Y, LUO L Y, et al. Transcutaneous electrical acupoint stimulation for post-traumatic stress disorder: assessor-blinded, randomized controlled study[J]. Psychiatry Clin Neurosci, 2019, 73(4): 179-186.
    [25]
    袁岚, 郭君, 唐炜, 等. 经皮穴位电刺激对腹腔镜肠道手术围术期胃肠道功能的影响[J]. 临床麻醉学杂志, 2017, 33(6): 567-569. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201706015.htm

    YUAN L, GUO J, TANG W, et al. Effect of transcutaneous electrical acupoint stimulation on gastrointestinal function in perioperative period of laparoscopic intestinal surgery[J]. Journal of Clinical Anesthesiology, 2017, 33(6): 567-569. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201706015.htm
    [26]
    郤丽娟, 王道荣, 方方, 等. 经皮穴位电刺激对术后神经认知功能影响的研究进展[J]. 护理研究, 2021, 35(12): 2163-2167. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202112019.htm

    XI L J, WANG D R, FANG F, et al. Research progress on the effect of transcutaneous electrical acupoint stimulation on postoperative neurocognitive function[J]. Chinese Nursing Research, 2021, 35(12): 2163-2167. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202112019.htm
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(9)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (192) PDF downloads(2) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return