经皮穴位电刺激对经鼻蝶入路鞍区占位切除患者术后早期认知功能的影响.docVIP

经皮穴位电刺激对经鼻蝶入路鞍区占位切除患者术后早期认知功能的影响 　　[摘要] 目的 探?经皮穴位电刺激对经鼻蝶入路鞍区占位切除患者术后早期认知功能的影响。 方法 选取首都医科大学三博脑科医院2015年8月～2016年3月收治的择期全麻下经鼻蝶入路鞍区占位切除患者80例，采用随机数字表法将其分为经皮穴位电刺激组（T组）和对照组（C组）。T组在麻醉诱导前30 min，取双侧太阳穴、左侧合谷穴及外关穴，行经皮穴位电刺激，刺激持续直至手术结束。C组无穴位刺激。运用神经心理测试（Stroop色词测试、数字符号替代测试、听觉语言学习测试）评定并记录术前1 d、术后3 d的认知功能变化，比较两组患者认知功能恢复情况。 结果 T组与C组术后认知功能障碍发生率比较，差异无统计学意义（2.5%比7.5%，P 0.05）。两组Stroop色词测试和数字符号替代测试结果比较差异无统计学意义（P 0.05）。C组术后听觉语言学习测试中延迟词语记忆个数显著少于术前（P 0.05）。 结论 经皮穴位电刺激对经鼻蝶入路鞍区占位切除患者术后早期认知功能无显著影响，但可能有改善术后记忆恢复能力的作用。 　　[关键词] 术后认知功能障碍；经皮穴位电刺激；经鼻蝶入路鞍区占位切除术；针刺麻醉 　　[中图分类号] R651 [文献标识码] A [文章编号] 1673-7210（2017）01（a）-0012-04 　　[Abstract] Objective To observe the impacts of transcutaneous electrical acupoint stimulation on postoperative cognitive function in patients undergoing transsphenoidal surgery. Methods Eighty patients undergoing transsphenoidal surgery in Sanbo Brain Hospital， Capital Medical University from August 2015 to March 2016 were enrolled and allocated randomly into transcutaneous electrical acupoint stimulation group （group T） and control group （group C） according to the random number table. In group T， the transcutaneous electrical acupoint stimulation skin electrodes were placed at acupoints Hegu （LI4） and Waiguan （TE5） on the left side， and bilateral Taiyang （EX-HN5）， and patients received transcutaneous electrical acupoint stimulation 30 minutes before induction and during the operation. Patients in group C did not receive transcutaneous electrical acupoint stimulation. The cognitive assessment was done by using a series of neuropsychological tests， including Stroop colour word tests， letter digit substitution test and visual verbal learning test at 1 day before the surgery and 3 days after the surgery， so as to compare the recovery conditions of cognitive function. Results There was no significant difference between group T and group C in the incidence of postoperative cognitive dysfunction （2.5% vs 7.5%， P 0.05）. There were no significant differences of Stroop colour wor