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[目的]探讨经皮穴位电刺激(TEAS)对直肠癌根治术患者围术期细胞因子及术后镇痛效果的影响。[方法]择期直肠癌根治术患者60例,年龄42～66岁,ASAI～Ⅱ级,随机分为对照组(I组)和TEAS组(Ⅱ组),每组30例。Ⅱ组从麻醉诱导前30min至术毕持续TEAS,术后连续3d行间断TEAS,刺激部位为双侧合谷和内关穴。术后行病人自控硬膜外镇痛。分别于入室后即刻(T1)、术毕(T2)、术后24h(T3)、48h(T4)、72h(T5)抽取外周静脉血,采用双抗体夹心酶联免疫吸附(ELISA)法测定血清IL-2、sIL-2R、IL-6及IL-10的浓度,采用视觉模拟评分法(VAS)评价患者术后4、12、24、48、72h的疼痛程度,记录术后镇痛药用量。[结果]2组入室后即刻血清IL-2、sIL-2R、IL-6、IL-10水平差异无统计学意义(P﹥0.05);与入室后即刻相比,I组术毕和术后24h、48hIL-2、术毕sIL-2R水平降低,Ⅱ组各时间点sIL-2R水平降低,2组IL-6水平升高(P﹤0.05);与I组相比,Ⅱ组术毕、术后24h、48h时IL-2水平升高、IL-6水平降低,术后24、48、72h时sIL-2R水平较低,术后48h和72h时IL-10水平升高,术后各时点VAS评分降低,术后镇痛药用量减少(P﹤0.05)。[结论]围术期经皮穴位电刺激可减轻直肠癌根治术后患者免疫功能抑制,增强术后镇痛效果,减少术后镇痛药的用量。
[Objective] To investigate the effects of percutaneous electro-acupuncture (TEAS) on perioperative cytokines and postoperative analgesia in patients undergoing radical resection of rectal cancer. [Methods] 60 patients with elective radical resection of rectal cancer, aged 42-66 years and ASAI ~ Ⅱ were randomly divided into control group (I group) and TEAS group (Ⅱ group), 30 cases in each group. The rats in group Ⅱ continued TEAS 30min before operation to anesthesia, and TEAS was discontinued in three consecutive days after operation. The stimulation sites were bilateral Hegu and Neiguan. Postoperative patient controlled epidural analgesia. Peripheral venous blood was collected immediately after admission (T1), at the end of surgery (T2), at 24h (T3), 48h (T4) and 72h (T5) respectively. Serum was detected by enzyme-linked immunosorbent assay The levels of IL-2, sIL-2R, IL-6 and IL-10 were evaluated by visual analogue scale (VAS) at 4,12,24,48,72h after operation. the amount. [Results] There was no significant difference in serum IL-2, sIL-2R, IL-6 and IL-10 levels between the two groups immediately after admission (P> 0.05) The level of sIL-2R in group Ⅱ decreased at each time point (P <0.05). Compared with group I, the level of sIL-2R decreased at 24h and 48hIL-2, The levels of IL-2 and IL-6 decreased at 24h and 48h after operation, the levels of sIL-2R at 24, 48 and 72h after operation were significantly lower, and IL-10 increased at 48h and 72h after operation VAS score decreased at the point, the amount of analgesics decreased (P <0.05). [Conclusion] percutaneous electrical acupuncture can reduce the immune suppression in patients with rectal cancer after surgery to enhance postoperative analgesic effect and reduce the amount of postoperative analgesics.