针麻下腹式全子宫切除63例临床观察

<正> 78年11月至79年11月在针麻下作腹式全子宫切除术63例。同时进行中医辨证及生理生化指标观察.麻醉成功率100%.优良率79.37%.麻醉方法一、穴位:共四对。头针:伏脏中焦透下焦(双),倒脏下焦透中焦(双).体针:次髎(双).五枢透维道(双).二、刺激条件:北航57-6D 针麻仪电脉冲,频率100次/秒,电流强度以病人耐受为度。诱导时间20分钟.

CLINICAL OBSERVATION ON HYSTERECTOMY THROUGH ABDOMEN IN CASES UNDER ACUPUNCTURE ANESTHESIA

Uuder acupuncture anesthesia at the acupoint of modified Ciliao(B1 32), Wushu through Weidao and scalp acupoint Fu Zang Zhongjiao through Xiajiao,63 cases of abdominal hysterectomy were performed under the electric pulse from a 57-5D acupuncture anesthesia instrument.The observa- tion according to the differentiation of symptoms of the Chinese traditional medicine,and the observation of physiological and biochemical data wet ecarri- ed out simultaneously.The anesthesia was successful with an excelletn rate of 79.37%.30 cases among got this 2-5 mW He-Ne laser radiation at Shangji- zhong,Yaoshu and other acupoints for 20 minutes before the induction.The result of anesthesia was apparently raised.The excellent rate was93.23%. Among these 63 cases there were 9 kinds of gynaecologieal diseases. The operations ranged from difficult to easy.The wide range of application indications of acupuncture anesthesia with its less side-effect were observed. The analgesic effect after operation was longer,and 66.7% of these cases did not take drugs.There were further favourable results such as the qui- cker recovery,earlier bowel movement to pass flatus and better wound healing.In 88% cases under traditional Chinese differential diagnostics of 24 hours after operation,the pulse pattern,and the tongue patterns were all recovered to the condition before operation.No one had the complicat- ion of anesthesia.The acupuncture anesthesia added a new method to the anesthesia in gynecological and obstetrical operations. Observation on physiological data:After the acupuncture induction,the blood volume wave of the finger vessels was enlarged,the skin temperature was gradually raised from less than 2.0℃ to 11℃.,which indicated that the blood vessels of the skin were relatively expanded.These phenomena could be related to the rising excitement of parasympathetic nerve system. It was in parallel with the result of the acupuncture anesthesia. The E-Rosette formation rate and immunological serum IgG diffusion test after the induction of acupuncture anesthesia and operation had various- amplitudes of rise in most cases,but the serum IgG and IgM were raised to an ap parently high level after operation(p<0.01).The strengthening of cell immu- nologieal function seemed to be related to the good recovery after operation. The authors realized that the single-needle endurance test was easy to be carried out and the conformation rate of the pre-test was higher. Those who had good results in pre-test were the patients with high basic pain thresholds,and their excellent results of ansthesia could reach up to 96%.In the analysis of various diseases the size of the uterus and tumor,the length of cervix of uterus and the other conditions had no direct relation with the anesthesia effectiveness,but the anesthesia results of the patients with hydatidiform mole and hysteromyoma and of patients with less adhesion and soft pelvic tissue were good:otherwise,the opera- tional skillfulness level of the operator was greatly related to the result of acupuncture anesthesia.Thus the latter three conditions should be the in- dications and main evidence in the case selection.