目的:探讨经皮穴位电刺激(TEAS)复合药物全麻行控制性降压对胃动力的影响,为临床针药复合麻醉提供实验依据.方法:雄性比格犬随机分为单纯药物全麻组(全麻组,6只)、单纯药物全麻行控制性降压组(控压组,6只)和TEAS复合药物全麻行控制性降压组(电刺激组,6只).后两组动物均以异氟烷联合硝普钠行控制性降压,将动脉血压降至基础平均动脉压(MAP)的40％,并维持60 min,电刺激组在此期间行双侧“合谷”足三里“三阴交”由池”TEAS干预处理.采用EGEG-26胃电图仪监测相应时间点胃电频率、振幅,采用酶联免疫吸附实验(定量)法检测血清胃动素、胃泌素水平的变化.结果:在目标低血压维持60 min(T3)时,与各自基础水平相比,控压组和全麻组胃电振幅有下降趋势,而电刺激组胃电振幅无明显下降;同时控压组胃泌素明显降低(P＜0.05).在血压回升结束(T4)时,电刺激组胃电振幅明显高于同期控压组和全麻组(P＜0.05)；其胃动素、胃泌素已接近基础水平,而控压组尚未恢复(P＜0.05).在血压回升结束后2 h(T5)时,电刺激组胃电振幅明显高于基础水平(P＜0.05),而控压组未明显升高；此时电刺激组胃泌素水平明显高于同期全麻组和控压组,而控压组胃动素、胃泌素仍未恢复(P＜0.05).在控压后72 h(T8),电刺激组胃泌素明显高于基础水平(P＜0.05),而同期全麻组和控压组均无明显升高.结论:TEAS复合药物全麻行控制性降压能有效改善控制性降压后胃电振幅、胃动素、胃泌素状况,以利于控压后胃动力的恢复,从而起到胃保护作用.%Objective To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) combined with general anesthesia on gastric dynamics in controlled hypotension dogs, so as to provide experimental evidence for compound acupuncture anesthesia. Methods Eighteen male beagle dogs were randomly divided into general anesthesia group (GA group, n = 6), general anesthesia + controlled hypotension group (GA+CHT group, n = 6) and general anesthesia combined with TEAS + controlled hypotension group (TEAS group, n = 6). The latter two groups were administered with the same anesthetics [iso-fluane inhalation and intravenous sodium nitroprusside (SNP)]for inducing controlled hypotension (being the 40% of the baseline level). Beagles of the GA group were not treated with controlled hypotension (the initial concentration of SNP = 1 μg/kg · min'1, and with an increase rate of 1 ug/kg · min-1 until the controlled hypotension phase). In the TEAS group, TEAS [2 Hz/100 Hz, (4± 1) mA]was applied to "Quchi" (L111) ,"Zusanli"(ST 36), "Hegu" (LI 4), and "Sanyinjiao" (SP 6) from the beginning of the stable physiological condition phase to the end of the controlled-low mean arterial pressure (MAP) phase. Electrogastrogram (EGG) was recorded, and serum gastrin (GAS) and motilin (MTL) contents were detected by enzyme-linked immunosorbent assay. Results Compared with the basic level, the amplitude value of EGG at 60 min after controlled hypotension in the GA+CHT group was significantly lower (P<0. 05) s while the amplitude level of EGG of the TEAS group at the time-point of MAP recovery was significantly higher than those of the GA and GA + CHT groups (P<0. 05). No significant changes were found among the 3groups in the frequency levels of EGG. At the time-points of MAP recovery and 2 h after MAP recovery, serum MTL and GAS levels in the TEAS group were close to their basic level (P>0. 05). And serum GAS level at the time-point of 2 h after MAP recovery in the TEAS group was considerably higher than those in the GA and GA+ CHT groups (P<0. 05). Twenty-four, 48 and 72 h after MAP recovery, serum GAS levels in the TEAS group were moderately (24 h and 48 h ) and significantly (72 h) higher than that of the basic level. No significant differences were found between the GA and GA+CHT groups in serum MTL and GAS levels at the time-points of 2, 24, 48 and 72 h after MAP recovery (P>0. 05). Conclusion TEAS combining with general anesthesia for controlled hypotension can improve the amplitude of EGG, and serum MTL and GAS contents, favoring the recovery of gastric dynamics and the functional protection of stomach.
展开▼
