韩氏穴位神经刺激仪辅助硬膜外麻醉用于急性阑尾炎手术的临？…

目的：观察普通外科急性阑尾炎病人在硬膜外麻醉时应用韩氏穴位神经刺激仪（ＨＡＮＳ）观察是否能减轻内脏牵拉反应及相应的血糖变化。结果：硬膜外麻醉加ＨＡＮＳ组及硬膜外麻醉对照组各５例。＋ＨＡＮＳ组有６０％（９／１５）的病人不出现牵拉反应,明显高于对照组１３．３％（２／１５）,两组差异非常显著（Ｐ〈０．０１）;＋ＨＡＮＳ组术中需追加哌替啶的病例１３．３％（２／１５）显著少于对照组５３％（８／１５）（Ｐ〈０     

应用HANS辅助硬膜外麻醉预防剖宫产内脏牵拉痛的临床研究

为探讨韩氏穴位神经刺激仪（ＨＡＮＳ）应用于剖宫产麻醉，是否能起到辅助麻醉，预防剖宫产时内脏牵拉前的作用。随机选择ＡＳＡ Ⅰ级急中择期剖宫产产妇４０例，分为两组：Ⅰ组（ＨＡＮＳ）组２０例，ＨＡＮＳ加硬膜外麻醉。Ⅱ组（对照组）２０例，单纯应用硬膜外麻醉。ＨＡＮＳ组将ＨＡＮＳ两对电极分别置于双侧足三里、三阴交穴位。频率１００Ｈｚ，强度为１０￣１５ｍＡ等幅刺激。诱导时间为１５￣２０分钟，持续３０￣７０分钟     

术前HANS对剖宫产术中及术后病人的镇痛作用

目的：观察术前应用韩氏穴位神经刺激仪（ＨＡＮＳ）对术后病人自控硬膜外镇痛（ＰＣＥＡ）效果、镇痛药用量及不良反应的影响。方法：选取ＡＳＡⅠ级剖宫产产妇４０例。ＨＡＮＳ组（ＨＡＮＳ＋ＰＣＥＡ组）２０例：术前应用ＨＡＮＳ且术后进行ＰＣＥＡ;对照组（ＰＣＥＡ组）２０例：单纯术后ＰＣＥＡ。ＨＡＮＳ采用ＤＤ波（２／１００Ｈｚ）刺激３０ｍｉｎ后切皮。记录切开腹膜、分离膀胱反折、婴儿娩出、清理宫腔、探查附件、术后     

韩氏（HANS）仪对七氟醚最低肺泡浓度（MAC）的影响

目的：将ＨＡＮＳ仪用于心血管手术的临床麻醉，观察其能否减少麻醉药的用量。方法：４０例５～１０岁先天性心脏病室间隔缺损（ＶＳＤ）、房间隔缺损（ＡＳＤ）患儿，随机分为Ⅰ组（单用七氟醚组）和Ⅱ组（ＨＡＮＳ加七氟醚复合组）。用体动反应上下交叉点（ｕｐａｎｄｄｏｗｎ）法分别测定两组的最低肺泡气浓度（ＭＡＣ）。结果：Ⅰ组即单用七氟醚组的ＭＡＣ值为２．７２±０．０７Ｖｏｌ％；而Ⅱ组即七氟醚加ＨＡＮＳ组的ＭＡＣ值为２．２４±０．１５Ｖｏｌ％，比空白组减少了１７．４％。两组间Ｐ值＜０．００１，有非常显著的区别。切皮的刺激使Ⅰ组的心率增加了３８．０％，收缩压增加了２３．０％，舒张压增加了３４．０％；而Ⅱ组即七氟醚加ＨＡＮＳ组心率增加了１６．０％，收缩压增加了１４．３％，舒张压增加了１３．７％。结论：ＨＡＮＳ可减少七氟醚的ＭＡＣ值１７．３８％，具有非常显著的统计学意义。在１ＭＡＣ左右，机体接受同样伤害性刺激时，ＨＡＮＳ具有一定的心血管稳定作用。     

韩氏穴位神经刺激仪（HANS）应用于腹部手术病人术后PCEA镇？…

本研究根据一定频率的经皮电刺激可促使中枢神经系统释放阿片肽的原理，应用韩氏穴位神经刺激仪（ＨＡＮＳ）辅助腹部手术病人术后硬膜外腔吗啡自控镇痛２０例（ＨＡＮＳ组）与单纯术后硬膜外腔吗啡自控镇痛２０例（对照组）比较。结果表明：吗啡和量ＨＡＮＳ组１５０±１９２．６μｇ与对照组４６５±４７８．２μｇ相比有显著性差异（Ｐ〈０．０５），镇痛效果ＶＡＳ评分ＨＡＮＳ组０．５±０．５１分与对照组０．９±０．６４分相     

ACTH及电针对甲醛痛敏大鼠脊髓NOS阳性神经元增多的影响

本文采用ＮＡＤＰＨ－ｄ组化染色技术,研究鞘内注射（ｉ．ｔ．）ＡＣＴＨ及电针刺激（ＥＡ）对甲醛痛敏大鼠脊髓背角浅层ＮＯＳ阳性神经元增多的影响。结果显示ＡＣＴＨ（０．５Ｕ,ｉ．ｔ．）及电针（１ｍＡ５０Ｈｚ,５ｍＡ５Ｈｚ,１ｍＡ５Ｈｚ）刺激“夹脊穴”３０ｍｉｎ均可显著抑制脊髓背角浅层ＮＯＳ阳性神经元增多;ｉ．ｔ．ＡＣＴＨ（０．５Ｕ）和电针刺激（１ｍＡ５Ｈｚ）同时给予时,抑制作用显著增加;ｉ．ｔ．ＮＯ前体     

血清可溶性白细胞介素-2受体水平在预测高血压急性脑出血手术治疗中的意义

目的：探讨血清可溶性白细胞介素２受体（ＳＩＬ２Ｒ）水平在预测高血压急性脑出血（ＨＡＣＨ）患者手术治疗中的意义。方法：采用双抗体夹心酶联免疫吸附法测定２０例正常人及４９例ＨＡＣＨ急性期手术和非手术患者血清ＳＩＬ２Ｒ含量。结果：ＨＡＣＨ患者入院当日血清中ＳＩＬ２Ｒ含量〔（０．５９２±０．０３７）Ｕ／Ｌ〕显著高于正常对照组〔（０．２３７±０．０６９）Ｕ／Ｌ〕；手术组患者术前与术后第１天和第１０天血清ＳＩＬ２Ｒ含量比较分别为无显著性差异（Ｐ＞０．０５）和有显著性差异（Ｐ＜０．０１）；手术组患者术后第１日和第１０日与非手术组患者血清ＳＩＬ２Ｒ含量同步比较分别为无显著性差异（Ｐ＞０．０５）和有显著性差异（Ｐ＜０．０５）；死亡患者入院当日血清ＳＩＬ２Ｒ含量〔（０．７４３±０．０４９）Ｕ／Ｌ〕高于存活组〔（０．５９８±０．０４４）Ｕ／Ｌ，Ｐ＜０．０１〕，且显著高于对照组〔０．２３７±０．０６８）Ｕ／Ｌ，Ｐ＜０．０１〕。结论：ＳＩＬ２Ｒ与ＨＡＣＨ患者免疫功能紊乱有关，动态测定血清ＳＩＬ２Ｒ含量，可作为观察ＨＡＣＨ病情发展变化的一项指标，同时对判断ＨＡＣＨ的预后亦有一定临床意义。     

HANS仪辅助硬膜外阻滞时病人血清皮质醇和血糖的变化

目的：观察妇科经腹全宫切除病人在硬膜外麻醉时辅以ＨＡＮＳ穴位刺激，是否能减轻内脏牵拉反应及相应的血液生化学变化。结果：硬膜外麻醉加ＨＡＮＳ组（＋ＨＡＮＳ）及单纯硬膜外麻醉（－ＨＡＮＳ）组各１５例。＋ＨＡＮＳ组术中有６６．７％的病例不出现牵拉反应，明显高于－ＨＡＮＳ组（２０％）；术中需要追加杜非合剂的病例（１３％），显著少于－ＨＡＮＳ组（５３％）。＋ＨＡＮＳ组术中血糖升高３３％，显著低于－ＨＡＮＳ组（升高４９％）。两组血清皮质醇水平的幅度相似，无显著差异。结论：硬膜外麻醉加用ＨＡＮＳ，可减轻手术牵拉反应及相应的升血糖反应     

大鼠脊髓5－羟色胺1A受体和1C／2受体亚型参与高频电针镇痛

通过脊髓蛛网膜下腔慢性埋植导管分别注射５－ＨＴ受体的多种拮抗剂，分析了大鼠脊髓５－ＨＴ受体的三个主要类型５－ＨＴ１、５－ＨＴ２和５－ＨＴ３受体在高频电针镇痛中的作用。实验结果表明：ｉ．ｔ．注射５－ＨＴ１Ａ受体拮抗剂ｓｐｉｐｅｒｏｎｅ２５μｇ不影响１００Ｈｚ电针的平均针效（Ｐ＞０．０５），但可阻断电针后效应（Ｐ＜０．０１）；ｉ．ｔ．注射５－ＨＴ１ｃ／２受体拮抗剂ｍｉａｎｓｅｒｉｎ５０μｇ可阻断１００Ｈｚ电针的平均针效，也可阻断电针后效应（Ｐ＜０．０１）；ｉ．ｔ．注射５－ＨＴ２受体拮抗剂１－ＮＰ２０μｇ和５－ＨＴ３受体拮抗剂ＩＣＳ２０５－９３０１００μｇ对１００Ｈｚ电针镇痛没有显著影响（Ｐ＞０．０５）。提示大鼠脊髓５－ＨＴ１Ａ受体和５－ＨＴ１ｃ／２受体参与介导１００Ｈｚ电针镇痛，而５－ＨＴ３受体可能不起主要作用。     

持续气道正压通气、T管及压力支持通气等条件下患者呼吸功的比较性研究

目的：探讨从呼吸功角度评价呼吸机脱机方式优劣的可能性及其意义。方法：通过ＢｉｃｏｒｅＣＰ１００呼吸监测仪测定２２例患者在压力支持通气（ＰＳＶ）、持续气道内正压（ＣＰＡＰ）通气、Ｔ管及拔管后２小时等条件下的呼吸功的变化。结果：ＣＰＡＰ０．４９ｋＰａ（１ｋＰａ＝１０．２０ｃｍＨ２Ｏ）、Ｔ管、ＰＳＶ０．４９ｋＰａ时，患者呼吸功依次逐渐降低。ＣＰＡＰ０．４９ｋＰａ时呼吸功（９．９８Ｊ／ｍｉｎ）比ＰＳＶ０．４９ｋＰａ时高２３．７％（Ｐ＜０．００１），比拔管后２小时高４８．５％（Ｐ＜０．０１），与Ｔ管时比较无显著性差异。Ｔ管时呼吸功（９．３１Ｊ／ｍｉｎ）比ＰＳＶ０．４９ｋＰａ时高１５．４％（Ｐ＜０．０５），比拔管后２小时高３８．５％（Ｐ＜０．０１）。结论：患者呼吸功因脱机方式不同而显著不同，ＰＳＶ０．４９ｋＰａ比ＣＰＡＰ０．４９ｋＰａ和Ｔ管更有利于脱机。     

Optimal stimulation frequency of transcutaneous electrical nerve stimulation on people with knee osteoarthritis.

OBJECTIVE: This is a double blind study that examined the optimal stimulation frequency of transcutaneous electrical nerve stimulation in reducing pain due to knee osteoarthritis. SUBJECTS: Thirty-four subjects were randomly allocated into 4 groups receiving transcutaneous electrical nerve stimulation at either: (i) 2 Hz; (ii) 100 Hz; (iii) an alternating frequency of 2 Hz and 100 Hz (2/100 Hz); or (iv) a placebo transcutaneous electrical nerve stimulation. METHODS: Treatment was administered 5 days a week for 2 weeks. The outcome measures included: (i) a visual analogue scale; (ii) a timed up-and-go test; and (iii) a range of knee motion. RESULTS: The 3 active transcutaneous electrical nerve stimulation groups (2 Hz, 100 Hz, 2/100 Hz), but not the placebo group, significantly reduced osteoarthritic knee pain across treatment sessions. However, no significant between-group difference was found. Similarly, the 3 active transcutaneous electrical nerve stimulation groups, but not the placebo group, produced significant reductions in the amount of time required to perform the timed up-and-go test, and an increase in the maximum passive knee range of motion. CONCLUSION: Our findings suggested that 2 weeks of repeated applications of transcutaneous electrical nerve stimulation at 2 Hz, 100 Hz or 2/100 Hz produced similar treatment effects for people suffering from osteoarthritic knee.     

Selective versus non-selective neural stimulation in the monitoring of muscular relaxation during general anesthesia

Aim. The depth of muscular relaxation during general anesthesia is monitored through the analysis of the contraction evoked by selective electrical stimulation of a peripheral nerve. The aim of this study was to compare the method of selective stimulation (SS) to a new method based on non-selective electrical stimulation (NSS) delivered over the muscle. Method. Electrical stimuli were delivered as train-of-four impulses to the ulnar nerve (SS) and to the ventral aspect of the contralateral forearm (NSS). The muscular responses of the adductor pollicis brevis (SS) and the forearm supinator longus (NSS) were studied at 30–60 s intervals with piezoelectric transducers before and after the administration of atracurium bolus doses of 0.5 mg/kg to patients under general anesthesia. SS and NSS evoked muscular responses were quantitized as percentages of the control response and compared with linear correlation and concordance analysis. Results. Twenty patients were studied. Basal and post-atracurium muscular responses were similar for the SS and the NSS methods. Precision between SS and NSS was > 85% and accuracy > 92%. Concordance was: basal < 15%, relaxation < 5%, recovery < 10%. Conclusion. NSS is equivalent to SS for muscular relaxation monitoring during general anesthesia. This has important implications to simplify muscular relaxation monitor design.     

韩氏穴位神经刺激仪对妇科腹腔镜术后疼痛与恶心呕吐的影响

目的:观察在妇科腹腔镜术前、后使用韩氏穴位神经刺激仪(Han’s Acupoint Nerve Stimulator,HANS),对术后疼痛与恶心呕吐症状的影响。方法:接受妇科腹腔镜手术患者91例,随机分配到3组:A组为术前30分钟使用安慰剂HANS,B组为术前30分钟使用HANS,C组为手术前与术后30分钟各使用HANS 30分钟。频率:2/100 Hz,取穴:一侧合谷-劳宫,对侧内关-外关。采用视觉模拟尺(visual analogue scale,VAS)在术后0.5、6、24小时分别评估患者疼痛与恶心呕吐的程度。结果:与A组比较,B组与C组在术后0.5、6、24小时的疼痛症状均有显著改善;也能显著改善术后30分钟时恶心呕吐症状。C组的治疗作用似优于B组,但差异未达显著水平。结论:术前使用,或者术前加术后使用HANS,能有效降低妇科腹腔镜术后疼痛与恶心呕吐症状。     

穴位体表电刺激治疗三叉神经痛28例报告

本文采用韩氏穴位神经刺激仪（ＨＡＮＳ）治疗三叉神经痛。通过体表电极对穴位施加刺激，刺激频率为２／１００Ｈｚ变频方波，刺激部位以双侧合谷为主穴，第一支配患侧“阳白”和“下关”；第二支配患侧“四白”和“颊车”及手背“落枕”穴；第三支配患侧“翳明”和“听会”。部分患者配合耳针治疗，治疗结果，２８例中有７例痊愈（沾２５％），显效、有效、无效各７例（各占２５％）。我们的结果表明，穴位体表电刺激可以作为治疗三     

Transcutaneous electrical nerve stimulation for low back pain. A comparison of TENS and massage for pain and range of motion

Patients with acute or chronic low back pain were treated in a double-blind study that compared transcutaneous electrical nerve stimulation at intense levels and gentle, mechanically administered massage. Transcutaneous electrical nerve stimulation produced significantly greater pain relief, based on two measures of the McGill Pain Questionnaire, and significant improvement in straight leg raising. There were no significant differences between the two groups in backflexion scores. Pain-relief scores and range-of-motion scores were significantly correlated. The results indicate that pain-relief scores provide valuable information and can easily be obtained from patients for whom pain is a major symptom.     

Differential bronchodilatory effects of terbutaline, diltiazem, and aminophylline in canine intraparenchymal airways.

OBJECTIVES: Intraparenchymal airways are involved in air flow regulation. Relaxation of intraparenchymal airways to volatile anesthetics varied by topographic location. This study was conducted to determine whether other bronchodilators (terbutaline, diltiazem, and aminophylline) relax bronchiolus to a greater degree than bronchus, as seen with volatile anesthetics. DESIGN: In vitro, controlled, randomized study. SETTING: Animal research laboratory. SUBJECTS: Adult dogs (n = 9). INTERVENTIONS: Proximal (outer diameter, 4-6 mm) and distal (outer diameter, 0.8-1.5 mm) airway rings of dogs were contracted in tissue baths with the effective concentration of acetylcholine that produces half the maximum response. Airway relaxant dose-response curves were constructed to measure isometric tension after administration of terbutaline (concentration range, 10(-8) to 10(-4) M), diltiazem (concentration range, 3 x 10(-7) to 1 x 10(-4) M), and aminophylline (concentration range, 10(-7) to 10(-4) M). MEASUREMENTS AND MAIN RESULTS: All three bronchodilators caused relaxation of the proximal and distal airways. At the maximum dose, diltiazem (maximum relaxation, 95%+/-2% [proximal], 94%+/-6% [distal]; p > .05) was the most efficacious, followed by terbutaline (maximum relaxation, 72%+/-13% [proximal], 55%+/-9% [distal]; p < .05) and aminophylline (maximum relaxation, 32%+/-10% [proximal], 35%+/-18% [distal]; p > .05. At the concentrations tested, they were equally efficacious. No significant differences in relaxation between proximal and distal airways were noted with diltiazem or aminophylline in the entire dose range. However, terbutaline relaxed the distal airway more than the proximal airway in the entire dose range. CONCLUSIONS: The results demonstrate that only terbutaline showed a differential airway relaxant effect between proximal and distal airways, as seen with volatile anesthetics.     

直腿抬高训练对腰椎间盘突出症术后康复的影响

目的:探讨腰椎间盘突出症行髓核摘除术者早期直腿抬高训练对术后康复的影响。方法:将髓核摘除术的腰椎间盘突出症120例患者,随机分为实验组和对照组。实验组拔除引流管后做直腿抬高康复训练;对照组术后第1周内适度下肢活动,术后7d后做直腿抬高运动。比较两组患者焦虑、抑郁发生率及治疗效果、治疗满意度。结果:实验组焦虑、抑郁发生率显著低于对照组(P<0.05),长期疗效治疗满意度明显优于对照组(P<0.05)。结论:腰椎间盘突出症行髓核摘除术者,早期直腿抬高训练可有利于患者的术后康复,提高患者的治疗满意度。     

Alternating frequencies of transcutaneous electric nerve stimulation: does it produce greater analgesic effects on mechanical and thermal pain thresholds?

OBJECTIVE: To determine whether alternating frequency transcutaneous electric nerve stimulation (TENS) at 2 and 100Hz (2/100Hz) has a more potent hypoalgesic effect than a fixed frequency at 2 or 100Hz in healthy participants. DESIGN: A single-blind randomized controlled trial with a convenience sample. SETTING: University physiotherapy department. PARTICIPANTS: Sixty-four healthy volunteers (32 men [mean age, 28.1+/-5.9y], 32 women [mean age, 27.7+/-5.6y]) were recruited and randomly divided into 4 groups. INTERVENTIONS: The 4 groups received TENS delivered at (1) 2Hz; (2) 100Hz; (3) 2/100Hz alternating frequency; and (4) no treatment (control group), respectively. Electric stimulation was applied over the anterior aspect of the dominant forearm for 30 minutes. MAIN OUTCOME MEASURES: Mechanical pain thresholds (MPTs) and heat pain thresholds (HPTs) were recorded before, during, and after TENS stimulation. The data were analyzed using linear mixed models, with group treated as a between-subject factor and time a within-subject factor. RESULTS: During and shortly after electric stimulation, HPT increased significantly in the alternating frequency stimulation group (P=.024). MPT increased significantly in both the 100Hz (P=.008) and the alternating frequency groups (P=.012), but the increase was substantially larger in the 100Hz group. CONCLUSIONS: Alternating frequency stimulation produced a greater elevation in the HPT, but a greater increase in the MPT was achieved using 100Hz stimulation.     

静输氧在全麻术后患者中的应用

目的探讨全麻术后患者应用静输氧的疗效。方法将90例全麻术后患者随机分为静输氧观察组(45例)及常规组(45例)。常规组采用术后常规方法治疗、护理,观察组在常规治疗、护理基础上应用静输氧治疗,观察治疗前、后两组患者的精神状态、经皮血氧饱和度及伤口愈合情况。结果两组治疗前经检验无显著差异。在治疗后60min、120min观察组经皮血氧饱和度与治疗前比较有显著性差异(P<0.01),而常规组治疗前后比较无差异(P>0.01)。治疗后7d两组伤口愈合、总显效率、总有效率有统计学差异。结论静输氧治疗全麻术后患者能快速提高经皮血氧饱和度,有效改善重要器官缺氧状况,恢复脑组织细胞能量代谢的正常状态,促进伤口愈合,减少感染。