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| 电针预刺激对老年患者髋关节置换术后谵妄的影响 |
| Effect of electroacupuncture pre-stimulation on postoperative delirium in elderly patients undergoing hip arthroplasty |
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| DOI：10.12089/jca.2025.11.010 |
| 中文关键词: 电针预刺激 老年 术后谵妄 自噬 髋关节置换术 |
| 英文关键词: Electroacupuncture pre-stimulation Aged Postoperative delirium Autophagy Hip arthroplasty |
| 基金项目:江苏省中医药科技发展计划青年人才项目（QN202215） |
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| 中文摘要: |
目的：观察电针预刺激对老年患者髋关节置换术后谵妄（POD）的影响。
方法：选择择期行髋关节置换术的老年患者72例，男35例，女37例，年龄65～89岁，BMI 18.5～28.0 kg/m2，ASAⅡ或Ⅲ级。采用随机数字表法将患者分为两组：电针预刺激组（E组）和对照组（C组）。E组于术前连续3 d每天同一时间接受电针预刺激“百会穴”“大椎穴”，持续30 min，C组不接受电针治疗。两组患者均在全身麻醉下行髋关节置换术。术后1、2、3 d采用意识模糊评估法（CAM）量表评估POD的发生情况。术前1 d、术后1 d采用ELISA法检测血清S100β及自噬相关蛋白LC3-Ⅱ、p62的浓度。
结果：与C组比较，E组POD的发生率明显降低（P<0.05）。与术前1 d比较，两组术后1 d的血清LC3-Ⅱ浓度明显升高，p62浓度明显下降（P<0.05）；C组术后1 d的血清S100β蛋白浓度明显升高（P<0.05）。与C组比较，E组术后1 d的血清S100β蛋白浓度明显降低，自噬相关蛋白LC3-Ⅱ明显升高，p62浓度明显降低（P<0.05）。
结论：电针预刺激“百会穴”“大椎穴”可明显降低老年患者髋关节置换术POD的发生，此过程可能通过激活自噬、上调自噬流水平实现。 |
| 英文摘要: |
Objective: To observe the effect of electroacupuncture pre-stimulation on postoperative delirium (POD) in elderly patients undergoing hip arthroplasty.
Methods: Seventy-two elderly patients scheduled for hip arthroplasty were enrolled, including 35 males and 37 females, aged 65-89 years, BMI 18.5-28.0 kg/m2, and ASA physical status Ⅱ or Ⅲ. The patients were randomly assigned to two groups: the electroacupuncture pre-stimulation group (group E) and the control group (group C). The group E received pre-stimulation of “Baihui” and “Dazhui” for 30 minutes at the same time every day for 3 consecutive days before surgery, while the group C did not receive electroacupuncture treatment. All patients underwent hip arthroplasty under general anesthesia. The occurrence of POD was evaluated using the confusion assessment method (CAM) scale on postoperative days 1, 2, and 3. The concentrations of serum S100β and autophagy-related proteins LC3-Ⅱ and p62 were detected by ELISA on the day before surgery and on postoperative day 1.
Results: The incidence of POD in group E was significantly lower than that in group C (P < 0.05). Compared with the day before surgery, the serum LC3-Ⅱ concentration in both groups significantly increased on postoperative day 1, and the p62 concentration significantly decreased (P < 0.05), the serum S100β protein concentration in group C significantly increased on postoperative day 1 (P < 0.05). Compared with group C, the serum S100β protein concentration in group E significantly decreased, the autophagy-related protein LC3-Ⅱ significantly increased, and the p62 concentration significantly decreased on postoperative day 1 (P < 0.05).
Conclusion: Electroacupuncture pre-stimulation of “Baihui” and “Dazhui” can significantly decrease POD in elderly patients undergoing hip arthroplasty. This effect may be achieved by activating autophagy and up-regulating the level of autophagic flux. |
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