Objective To evaluate the effects of transcutaneous electric stimulation of acupuncture points (TEAS)on perioperative T-lymphocyte immune function and postoperative analgesia in patients undergoing radical rectal cancer operation.Methods Sixty ASA Ⅰ or Ⅱ patients of both sexes aged 40-64 yr undergoing elective radical rectal cancer operation were randomly divided into 2 groups(n=30 each):Ⅰ control group and Ⅱ TEAS group.The operation was performed under general anesthesia combined with epidural block in both groups.The patients were unpremedicated.Anesthesia was induced with midazolam,fentanyl,propofol and vecuronium and maintained with isoflurane inhalation and intermittent iv boluses of vecuronium supplemented with epidural block.The patients were mechanically ventilated after tracheal intubation.Epidural catheter was inserted into epidural space at T12-Ll interspace and was advanced 4 cm cephalad.Correct placement of the epidural catheter was identified by a test dose of 5 ml 1.33% lidocaine.In TEAS group bilateral He-gu and Nei-guan were stimulated with an electric stimulator for 30 min before induction of anesthesia.TEAS was continued throughout the operation,and was performed 30 min a day for 5 days after operation.All of the patients received patient-controlled epiduralanalgesia(PCEA)after operation.Blood samples were taken before induction of anesthesia,at the end of operation and on the 1st,3rd 5th day after operation for determination of CD3+,CD4+ and CD8+ levels and CIM+/CD8+ ratio.VAS scores and the total amount of analgesics consumed were recorded.Results The CD3+ and CD4+ levels and CD4+/CD8+ ratio were significantly higher after operation in TEAS group than in control group.VAS scores were significantly lower and significantly less PCEA solution was consumed in TEAS group than in control group.Conclusion TEAS can attenuate the suppression of T-lymphocyte immune function and decrease analgesic requirement after radical rectal cancer operation.

目的 研究经皮穴位电刺激(TEAS)对胃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 择期胃癌根治术患者40例,年龄39～64 岁,ASAⅠ级或Ⅱ级,随机分为对照组(Ⅰ组)和TEAS组(Ⅱ组),每组20例.Ⅱ组从麻醉诱导前30 min至术毕行持续TEAS,术后连续3 d行间断TEAS,刺激部位为单侧合谷-劳宫穴和双侧足三里穴.术后行病人自控硬膜外镇痛.分别于入室后即刻、术毕、术后24、72 h抽取外周静脉血,测定血清IL-2、IL-12、IL-6及可溶性白细胞介素-2受体(SIL-2R)的浓度,采用视觉模拟评分法(VAS)评价患者术后2、24、48、72 h的疼痛程度,记录术后镇痛药用量及术后肠蠕动恢复时间.结果 2组入室后即刻血清IL-2、SIL-2R、IL-12、IL-6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24 h IL-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24 h时IL-2水平较高、IL-6水平较低,术后24 h、72 h时SIL-2R水平较低,术后72 h时IL-12水平较高,术后各时间点VAS评分降低,术后镇痛药用量减少,术后肠蠕动恢复时间缩短(P＜0.05).结论 围术期经皮穴位电刺激可减轻胃癌根治术后患者免疫功能抑制并可减少术后镇痛药的用量.