ABSTRACT
Objective:To evaluate the effect of transcutaneous electrical stimulation of different acupoints on pulmonary ventilation function in the patients undergoing laparoscopic cholecystectomy.Methods:Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, with body mass index of 18.5-25.0 kg/m 2, undergoing elective laparoscopic cholecystectomy, were divided into 3 groups ( n=20 each) using a random number table method: control group (group C), Zusanli-Sanyinjiao group (group S 1) and Feishu-Chize group (group S 2). Pulmonary ventilation function was monitored by electrical impedance tomography after admission to the operating room, group S 1 and group S 2 underwent transcutaneous electrical stimulation of bilateral Zusanli-Sanyinjiao and Feishu-Chize acupoints at 30 min before induction of anesthesia, with disperse-dense waves, a frequency of 2/100 Hz and the wave width of 0.6 ms at 2 Hz and 0.2 ms at 100 Hz.The intensity of stimulation was the maximum current that patients could tolerate.In group C, electrodes were only placed without electrical stimulation.The percentages of area in center of ventilation (CoV) and tidal volume in the dependent areas were determined on admission to the operating room (T 1), at 5 min after tracheal intubation (T 2), at 15 min after pneumoperitoneum (T 3), and at 30 min after removal of the tracheal tube (T 4). The extubation time and development of hypoxemia and atelectasis within 48 h after tracheal extubation were recorded. Results:Compared with the baseline at T 1, the percentages of area in CoV and tidal volume in dependent areas at T 3-4 were significantly decreased in S 1 and S 2 groups ( P<0.05). Compared with group C, the percentage of tidal volume in dependent areas at T 4 was significantly increased, and the extubation time and incidence of hypoxemia and atelectasis within 48 h after tracheal extubation were decreased in S 1 and S 2 groups ( P<0.05). Compared with group S 1, the percentage of tidal volume in dependent areas at T 4 was significantly increased, and the incidence of hypoxemia within 48 h after tracheal extubation was decreased in group S 2 ( P<0.05). Conclusions:The efficacy of transcutaneous electrical stimulation of Feishu-Chize acupoints in improving pulmonary ventilation function is better than that of Zusanli-Sanyinjiao acupoints in the patients undergoing laparoscopic cholecystectomy.
ABSTRACT
Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on function of lung ventilation in the patients undergoing laparoscopic cholecystectomy using electrical impedance tomography (EIT).Methods:Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, with body mass index of 18.5-24.9 kg/m 2, undergoing elective laparoscopic cholecystectomy, were divided into 2 groups ( n=30 each) using a random number table method: control group (CON group) and TEAS group.EIT was carried out after entering the operating room.In group TEAS, bilateral Feishu (BL13) and Chize (LU5) acupoints were stimulated, while stimulation electrodes were only placed without electricity in group CON.The percentages of area in center of ventilation and tidal volume in the dependent areas were determined on admission to the operating room (T 1), at 5 min after tracheal intubation (T 2), at 5 min after CO 2 pneumoperitoneum (T 3), at 5 min after CO 2 was exhausted (T 4), and at 5 and 30 min after removal of the tracheal tube (T 5, 6). Radial artery blood samples were collected for blood gas analysis at T 1, T 3 and T 6, and the oxygenation index (OI) and alveolar-arterial oxygen difference (A-aDO 2) were calculated.Blood samples were taken from the peripheral vein at T 1, T 3 and T 6 for determination of the serum concentrations of Clara cell secretion protein (CC16), interleukin (IL)-6 and tumor necrosis factor (TNF)-α. Results:Compared with the baseline at T 1, the percentages of area in center of ventilation and tidal volume in dependent areas at T 2-6 and OI and A-aDO 2 at T 6 were significantly decreased, and the serum concentrations of TNF-α, IL-6 and CC16 were increased at T 3 and T 6 in two groups ( P<0.05). Compared with group CON, the percentage of tidal volume in dependent areas at T 5, 6 and OI at T 6 were significantly increased, and A-aDO 2 and serum concentrations of TNF-α, IL-6 and CC16 were decreased at T 6 in group TEAS ( P<0.05). Conclusions:TEAS can improve the function of lung ventilation in the patients undergoing laparoscopic cholecystectomy.
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Objective To investigate the clinical value of platelet parameters in patients with acute myocardial infarction(AMI) in plateau.Methods A total of 72 patients diagnosed as acute myocardial infarction in our department from January 2016 to June 2017 were enrolled into this study.Clinical data and outcomes were analyzed.Platelet parameters were measured within 24 h after AMI occurrence.The relationship between platelet distribution width (PDW),mean platelet volume (MPV),and the severity of disease,infarct size as well as short-term prognosis were further investigated.Results Compared with control group,PDW and MPV were positively correlated with the severity of disease (PPDW=0.039,PMPV=0.038) and infarct size (rPDW=0.305,P=0.009;rMPV=0.263,P=0.025).The AUC of PDW was 0.827,optimal operating point (OOP) was 16.3％,the AUC of MPV was 0.813,OOP was 13.1 fl,the AUC of GRACE was 0.865,OOP was 145.Conclusions PDW and MPV could be regarded as laboratory index to evaluate the severity of disease,infarct size,pathological changes of coronary artery and short-term prognosis of acute myocardial infarction in plateau.