经皮穴位电刺激联合右美托咪啶对老年患者术后谵妄的影响

Abstract
Figure/Table
References (25)
Related Citation (15)

Download: PDF (523 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) combined with Dexmedetomidine (DEX) on postoperative delirium (POD) in elderly patients. Methods From January 2017 to November 2018, 96 cases with elderly patients underwent pedicle screw internal fixation under elective general anesthesia in Beijing Hospital of Traditional Chinese Medicine, Capital Medical University were selected. According to the random number table method, they were devided into DEX group (group D) and combination group (group T), with 48 cases in each group. Group D was used DEX before anesthesia induction, while group T was used TEAS in combination on the basis of group D, and both groups stopped the above treatment 30 min before the end of the operation. The incidence of POD was compared within 5 d after operation. The does of Propofol was compared. Neuron-specific enolase (NSE), serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and superoxide dismutase (SOD) levels in the two groups were compared within 1 d before operation and 1, 5 d after operation. Results There was no significant difference in POD incidence between the two groups (P > 0.05). The dose of Propofol in group T were lower than that in group D, and the differences were statistically significant (P < 0.05). In group D, the levels of NSE, TNF-α, and IL-6 on 1, 5 d after operation were higher than those on 1 d before operation, while the levels of SOD were lower than that on 1 d before operation, with statistically significant differences (all P < 0.05). The levels of NSE, TNF-α, and IL-6 on 5 d after operation were lower than those on 1 d after operation, while the levels of SOD were higher than those on 1 d after operation, with statistically significant differences (all P < 0.05). In group T, the levels of NSE, TNF-α and IL-6 on 1 d after operation were higher than those on 1 d before operation, while the levels of SOD were lower than those on 1 d before operation, with statistically significant differences (all P < 0.05). The levels of IL-6 on 5 d after operation were higher than those on 1 d before operation, and the differences were statistically significant. The levels of NSE, TNF-α, and SOD on 5d after operation were not statistically significant compared with those on 1 d before operation (all P > 0.05). The levels of NSE, TNF-α, and IL-6 on 5 d after operation were lower than those 1 d after operation, while the levels of SOD were higher than those 1 d after operation, with statistically significant differences (all P < 0.05). Conclusion TEAS combined with DEX do not reduce the incidence of POD in elderly patients, but can reduce intraoperative Propofol dosages, inhibit inflammatory response and reduce brain injury.

Key words： Transcutaneous electrical acupoint stimulation Dexmedetomidine Postoperative delirium Inflammation reaction

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	DING Lingling KOU Shishun WANG Qi KE Hai YU Bo LU Bin SUN Weiming ZHOU Ruiling

Cite this article:

DING Lingling KOU Shishun WANG Qi KE Hai YU Bo LU Bin SUN Weiming ZHOU Ruiling. Effect of transcutaneous electrical acupoint stimulation combined with Dexmedetomidine on postoperative delirium in elderly patients[J]. 中国医药导报, 2020, 17(4): 123-126.

URL:

http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I4/123

[1] Bryson GL，Wyand A. Evidence based clinical update：general anesthesia and the risk of delirium and postoperative cognitive dysfunction [J]. Can J Anaesth，2006，53（7）：669-677.
[2] Silverstein JH，Timberger M，Reich DL，et al. Central nervous system dysfunction after non-cardiac surgery and anosthesia in the elderly [J]. Anesthesiology，2007，106（3）：622-628.
[3] Aldecoa C，Bettelli G，Bilotta F，et al. European Society of Anaesthesiology evidence-based and consensus based gui-deline on postoperative delirium [J]. Eur J Anaesthesiol，2017，34（4）：192-214.
[4] 张陈麟，朱玲丽，严栋.电针对老年患者全身麻醉术后认知功能恢复的影响[J].上海针灸杂志，2015，34（2）：132-134.
[5] 杨星月，赵宏，刘佳，等.针刺在国内外腰痛指南中的应用现状[J].中国针灸，2019，39（8）：908-912.
[6] Duan X，Coburn M，Rossaint R，et al. Efficacy of perioperative dexmedetomidine on postoperative delirium：systematic review and meta-analysis with trial sequential analysis of randomised controlled trials [J]. Br J Anaesth，2018， 121（2）：384-397.
[7] Kim JA，Ahn HJ，Yang M，et al. Intraoperative use of dexmedetomidine for the prevention of emergence agitation and postoperative delirium in thoracic surgery：A randomized-controlled trial [J]. Can J Anaesth，2019，66（4）：371-379.
[8] Sepulveda E，Franco JG，Trzepacz PT，et al. Delirium diagnosis defined by cluster analysis of symptoms versus diagnosis by DSM and ICD criteria：diagnostic accuracy study [J]. BMC Psychiatry，2016，16：167.
[9] Yang Y，Zhao X，Dong Ｔ，et al. Risk factors for postoperative delirium following hip fracture repair in elderly patients：asystematic review and meta analysis [J]. Aging Clin Exp Res，2017，29（2）：115-126.
[10] Neerland BE，Hsll RJ，Seljeflot I，et al. Associations between delirium and preoperative cerebrospinal fluid creactive protein，interleukin-6，and interleukin-６ receptor in individuals with acute hip fracture [J]. J Am Geriatr Soc，2016，64（7）：1456-1463.
[11] Chen LP，Wang FW，Zuo F，et al. Clinical research on comprehensive treatment of senile vascular dementia [J]. J Tradit Chin Med，2011，31（3）：178-181.
[12] Liu F，Li ZM，Jiang YJ，et al. A meta-analysis of acupuncture use in the treatment of cognitive impairment after stroke [J]. J Altern Complement Med，2014，20（7）：535-544.
[13] 陆斌，王麒，丁玲玲.经皮穴位电刺激对腹腔镜胆囊切除术患者术后早期恢复质量的影响[J].中国医药导报，2019，16（13）：112-115,119.
[14] 李莉，吕艳，翟翔隽，等.右美托咪定对穴位电刺激产妇分娩镇痛效果的影响[J].中外医学研究，2018，16（4）：1-3.
[15] 区燕云，李冬芬，何煜才，等.经皮穴位电刺激配合康复锻炼干预方案对危重症多发性神经病患者下肢运动功能的改善效果[J].中国医药科学，2019，9（1）：180-182，186.
[16] 吴晓珲，陈文婷.经皮穴位电刺激辅助全麻对老年心脏手术患者术后免疫功能和认知功能的影响[J].中国医药导报，2019，16（9）：145-148，157.
[17] Feng X，Yang S，Liu J，et al. Electroacupuncture ameliorates cognitive impairment through inhibition of NF-κB-mediated neuronal cell apoptosis in cerebral ischemia-reperfusion injured rats [J]. Molecular Medicine Reports，2013，7（5）：1516-1522.
[18] Su X，Meng ZT，Wu XH，et al. Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery：A randomised，double-blind，placebo-controlled trial [J]. Lancet，2016，388（10 054）：1893-1902.
[19] 丁玲玲，张宏，米卫东，等.右美托咪啶对老年患者在机器人辅助腹腔镜手术麻醉苏醒期及术后认知功能的影响[J].中南大学学报：医学版，2015，40（2）：129-135.
[20] 李莉，吕艳，翟翔隽，等.右美托咪定对穴位电刺激产妇分娩镇痛效果的影响[J].中外医学研究，2018，16（4）：1-3.
[21] 刘军，董友靖.右美托咪定对心肌缺血-再灌注损伤大鼠的心肌保护作用及机制[J].临床和实验医学杂志，2018， 17（23）：2476-2479.
[22] Deiner S，Luo X，Lin HM，et al. Intraoperative infusion of dexmedetomidine for prevention of postoperative delirium and cognitive dysfunction in elderly patients undergoing major elective noncardiac surgery：A randomized clinical trial [J]. JAMA Surg，2017，152（8）：e 171 505.
[23] Leung JM，Leung CW，Leung CM，et al. Clinical utility and validation of two instruments（the Confusion Assessment Method Algorithm and the Chinese version of Nursing Delirium Screening Scale）to detect delirium in geriatric inpatients [J]. Gen Hosp Psychiatry，2008，30（2）：171-176.
[24] 魏风，陈俭.神经元特异性烯醇化酶在颅脑损伤中的研究进展[J].医学综述，2012，18（1）：13-15.
[25] Kessler FH，Woody G，Portela LV，et al. Brain injury markers（S100B and NSE）in chronic cocaine dependents [J]. Braz J Psychiatry，2007，29（2）：134-139.