郑洁++胡滨++刘庆

[摘要] 目的 评价关元穴-足三里联合针刺用于防治七氟醚肾损伤的安全性及有效性。方法 随机选择全麻下行断指再植患者60例。采取随机双盲法分为两组，每组30例。A组七氟醚-瑞芬太尼麻醉，辅以关元穴-足三里联合针刺组，B组七氟醚-瑞芬太尼麻醉组。观察记录两组患者麻醉前、术后即刻、麻醉后24 h、48 h的血清尿素氮、 血肌酐情况，测定两组患者麻醉前、术后即刻、麻醉后24 h、48 h的超氧化物歧化酶、丙二醛情况。结果B组术后即刻、术后24 h、术后48 h血肌酐升高明显高于A组（P<0.05）；A组术后即刻、术后24 h、术后48 h超氧化物歧化酶浓度明显高于B组（P<0.05）。 结论 关元穴-足三里联合针刺用于防治七氟醚肾损伤安全性、有效。

[关键词] 关元穴-足三里联合针刺；七氟醚；肾损伤

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2014）10（b）-0007-02

Clinical Research of Guanyuan Combined with Zusanli Acupuncture for the Prevention and Treatment of Renal Injury Due to Sevoflurane

ZHENG Jie HU Bin LIU Qing

Department of Anesthesiology， Luzhou Medical College Affiliated Hospital of Traditional Chinese Medicine， Luzhou， Sichuan Province， 646000， China

[Abstract] Objective To evaluate the safety and effectiveness of Guanyuan combined with Zusanli acupuncture for the prevention and treatment of renal injury due to sevoflurane. Methods 60 cases underwent severed finger reunion under general anesthesia were randomly selected and divided into two groups according to the randomized double-blind method with 30 cases in each. Group A were given sevoflurane-remifentanil anesthesia， supplemented by Guanyuan combined with Zusanli acupuncture， and group B were given sevoflurane-remifentanil anesthesia. The serum urea nitrogen， serum creatinine before anesthesia， immediately after operation， 24 h， 48h after anesthesia of the two groups were observed and recorded. And the superoxide dismutase， malonaldehyde were measured in the two groups before anesthesia， immediately after operation， 24 h， 48 h after anesthesia. Results The elevated serum creatinine levels of group B immediately after operation， 24 h and 48h after operation were obviously higher than those of group A（P<0.05）； the superoxide dismutase concentration of group A immediately after operation， 24 h and 48h after operation were significantly higher than those of group B（P<0.05）. Conclusion Guanyuan combined with Zusanli acupuncture is safe and effective in the prevention and treatment of renal injury due to sevoflurane.

[Key words] Guanyuan combined with Zusanli acupuncture； Sevoflurane； Renal injury

七氟醚作为一种新型的麻醉药具有诱导期短、术后恢复快等优点已经广泛应用于各种麻醉手术中，但是越来越多学者提出长时间七氟醚麻醉是否存在术后躁动、损害肾功等缺点。足三里、关元穴是防病和抗衰老的重要穴位，该研究2013年7月—2014年7月拟评价关元穴-足三里联合针刺用于防治七氟醚肾损伤的安全性及有效性，现报道如下。

1 资料与方法

1.1 一般资料

随机选择全麻下行断指再植患者60例。采取随机双盲法分为2组，每组30例。ASA I～Ⅱ级，年龄28～49岁，体重47～71 kg。患者无明显心肺、肝肾功能疾病，无糖尿病、甲亢等代谢疾病。A组30例，其中男性22例，女性8例，外伤导致3～4根手指完全离断，拟在急诊下行断指再植术，平均年龄（41.9±6.1）岁，体重（61.9±5.1）kg，手术时间（6.9±1.7）h；B组30例，外伤导致3～4根手指完全离断，拟在急诊下行断指再植术，其中男性20例，女性10例，平均年龄（45.1±6.7）岁，体重（65.1±5.7）kg，手术时间（6.4±1.9）h。……