穴位针刺复合颈丛阻滞对甲状腺手术中内皮素与循环功能的影响

目的 观察穴位针刺对颈丛阻滞后副反应的抑制效应及血浆内皮素（ET）的变化，探讨其在循环变化中可能起的作用。方法 20例ASAI－Ⅱ级甲状腺手术病人，随机分为对照组（A组）和观察组（B组），每组10例，均采用一针法颈丛阻滞，局麻药为0．375％布比卡因（不含肾上腺素）。B组同时加用电针双侧合谷、内关穴。结果 A组麻醉后SBP、DBP和HR均上升，同期血浆ET增加，以麻醉后20分钟增加明显（P＜0．01）；经相关分析ET与SBP、DBP、HR呈弱正相关。而B组麻醉后SBP、DBP、HR仅轻度上升（P＞0．05），ET全程下降。结论 穴位针刺可以通过改善病人血管内皮细胞的功能状态、降低ET、平衡缩血管物质，从而稳定颈丛阻滞后的循环功能。

The effects of acupuncture combined with cervical plexus block on plasma endothelin and circulatory function during thyroid surgery

Objective To investigate the effect of acupuncture combined with cervical plexus block on plasma endothelin(ET) in patients undergoing thyroid operation and the relationship between ET and circulatory function.Methods 20 patients undergoing selective thyroid surgery were randomly divided into group A and group B with 10cases each.Cervical plexus block was performed by single puncture with 0 375% bupivacaine.The patients of group B were simultaneously given an electroacupuncture anesthesia.Results SBP,DBP and HR were increased in group A and plasma ET was increased at the same time,especially at 20 min after anesthesia( P< 0 01).A weak linear regressionship between ET and the changes of BP and HR was found.In group B SBP,DBP and HR were slightly increased( P> 0 05) and plasma ET was decreased during anesthesia.Conclusion The acupuncture treatment could improve the functions of endothelincytes resulting in a decrease of secretion of ET and stability of the circulatory function during cervical plexus block.