针药结合麻醉估价针麻效果及其临床意义

<正> 我们于1980年1月～10月采用针药结合施行胃大部切除及对照组共39例。现初步报告如下:方法一、观察对象:选取单纯溃疡病,手术难度大致相等的胃大部切除术的病员共39例,分成针药结合麻醉组19例,女2例,男17例;年龄最小23岁,最大55岁,硬膜外麻醉组20例,女4例,男16例;年龄最小25岁,最大60岁。

STUDY ON ACUPUNCTURE-DRUG COMBINED ANESTHESIA FOR EVALUATION OF THE EFFECT OF ACUPUNCTURE ANESTHESIA AND ITS CLINICAL SIGNIFICANCE

This paper presents 19 cases of subtotal gastrectomies performed under“acupuncture-drug combined anesthesia”and 20 cases of the same operationwith simple epidural block(as a control)with the mere purpose of studyingthe effect of acupuncture anesthesia.Epidural block was used in both groups.To the cases of the former,needle puncturing and electric stimulation on Zusanli and Shangjuxu pointswere added bilaterally.The primary requisition for the anesthesia was thatthe dosage of 1.6% lidocaine to be injected into epidural space must efficien-tly provide against pain through the operation.The total dose and the meandose per hour of the drug used were calculated.A formula was designed toevaluate the actual efficacy of acupuncture anesthesia(NSI).The formulawas designed as follows.NSI=mX-nX/mX ×100mX represents mean dose milliliter of 1.6% lidocaine used in control groupper hour.nX represents mean dose milliliter of 1.6% lidocaine used for acupuncture-drug combined anesthesia group.The calculated results for mX and nX were as follows:mX=13.0±2.5nX=8.9±2.5(p<0.01)This would mean that if the operation was made under the anesthesia ofboth drug and acupuncture,the dose of the drug would be smaller than that without acupuncture.Statistical analysis indicated that there was significantdifference between them,Using the formula designed above,then31.5%(NSI=13-8.9/13×100)was obtained.The result showed that tak-ing anesthesia effect as a whole there would be 31.5% due to the effect ofthe acupuncture.The E-rosette formation counts were performed in 17 cases with acu-puncture-drug combined anesthesia and 11 cases with simple epidural blockbefore and 30 minutes after the anesthesia,60 minutes after starting the opera-tion and also 24 hours after the operation.The percentage of the E-rosetteof two groups were then compared and the results showed that the percentageof E-rosette formation rate was significantly decreased at 30 minutes afteranesthesia and 60 minutes after starting the operation,with the t-values of2.1116 and 2.7778(p<0.05)respectively.In the simple epidural block group,the t-value of 30 and 60 minutes were 4.5475 and 3.7331(p<0.01)respec-tively.Evidently,the percentage of E-rosette formation rate of simple epi-dural block group decreased more markedly.The results of this study indicated that combined anesthesia with drugand acupuncture may have the following valuable points:Decrease of the dosage of anesthesia drug;Slight depression of immune reaction.Besides,the designed formula may be useful to evaluate the acupunctureeffect in anesthesia.