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Effective means to solve a variety of organic heart disease including congenital heart disease, rheumatic heart disease, coronary heart disease, including heart surgery. As we all know, the cause of cardiopulmonary bypass heart surgery in patients with myocardial ischemia and reperfusion injury (Ischemic Reperfusion Injury IRI) and postoperative cognitive dysfunction (Postoperative cognitive dysfunction, POCD), occurred. Although often used in low temperature, drugs, ischemic preconditioning on myocardial protection in clinical, but still there are varying degrees of myocardial ischemia, hypoxia, seriously affect the patient's post-operative recovery and quality of life. Studies have shown that the incidence of postoperative cognitive dysfunction caused by cardiac surgery was significantly higher than that of ordinary surgery. Therefore, how to prevent and treat cardiac ischemia-reperfusion injury and postoperative cognitive dysfunction has been a hotspot of medical research. Our previous study found that electroacupuncture preconditioning can be simulated brain protective effect of ischemic preconditioning reduced infarct volume and improve neurological score. In this study, the electricity preconditioning method, given pretreatment with repeated electroacupuncture anesthesia cardiopulmonary bypass heart valve replacement surgery in patients with myocardial protective effect, at the same time, to explore the application of EA pretreatment methods to prevent anesthesia cardiopulmonary bypass under observation possible cardiac surgery POCD occurred. EA pretreatment prior to cardiopulmonary bypass, heart valve replacement surgery in patients with intraoperative myocardial protection purpose of the first part of the EA pretreatment downstream the heart valve replacement surgery in patients with myocardial protective effects of anesthesia during cardiopulmonary bypass. Methods elective the downstream heart valve replacement surgery in general anesthesia during cardiopulmonary bypass in patients with 60 (27 male, 33 female) patients, aged 40-70 years, cardiac function grade Ⅱ ~ Ⅲ (NYHA criteria). Randomly divided into of electroacupuncture preconditioning group and control group (American Journal of Clinical registration number: NCT00732459). Patients with bilateral Neiguan (PC6) Lieque \Goods Co., Ltd.). Specific implementation method as follows: given the density wave, frequency regulation 1.5 (sparse wave 5-6Hz, dense wave 25-30Hz), depending on the patient's reaction intensity was adjusted to 2-4 (2.34-6.24mA), 30 min / d continuous treatment 5 d. Preoperative aortic 1h, 6h, 12h, 24h, 48h, 72h collecting blood samples, determination of cardiac troponin I (cTnI) levels; recorded intraoperative cardiopulmonary bypass time, aortic occlusion time, arrest indicators as well as the calculation of fluid volume, cardiac resuscitation, ICU stay time patients stay in the ICU score of positive inotropic drugs. Electroacupuncture pretreatment serum troponin I (cTnI) levels in the preoperative compared with the control group was not statistically significant, overall in subsequent time points to elevated levels lower than those in the control group, electro-acupuncture preconditioning group in the main artery clamp open after 6h, 12h, 24h, and the control group compared to the statistical significance (P lt; 0.05); electro-acupuncture preconditioning group at the time of ICU stay shorter than the control group, a statistically significant; entering the two groups ICU after 12h, 24h, 48h of positive inotropic drugs rated electro-acupuncture preconditioning group than the control group, a statistically significant (P lt; 0.05). Conclusion Preoperative give EA pretreatment of anesthesia, cardiopulmonary bypass cardiac valve replacement surgery in patients with myocardial protective effect. Part II: electroacupuncture preconditioning of cardiac surgery in patients with early cognitive dysfunction Objective To observe the preoperative give EA pretreatment look directly at the surgery in patients with early cognitive dysfunction incidence of cardiopulmonary bypass cardiac anesthesia. Elective anesthesia cardiopulmonary bypass coronary bypass surgery and heart valve replacement surgery patients 106 (49 male, 57 females) were randomly divided into two groups of electro-acupuncture preconditioning group and the control group. Electroacupuncture preconditioning group for five consecutive days before surgery given electroacupuncture preconditioning, specimens were obtained at bilateral Neiguan (PC6) Lieque \(\Respectively, before surgery (to give electroacupuncture pretreatment ago) after 7d and 14d after neuropsychological evaluation of all patients, the summary Intelligence Scale digit symbol test, digit span test loop connection test and story memory test 5 test. Results actually involved a complete assessment of the patients with a total of 75 cases, including EA pretreatment group of 38 cases, 37 cases of the control group. General information and operative time and the total amount of anesthetic drugs in two groups of patients with gender, age, height, body mass index, education age differences were not statistically significant (P gt; 0.05). EA pretreatment group and the control group after 7 d POCD rates were 26% and 24%, the incidence of postoperative 14 d POCD were 10% and 14%, the difference between the two groups was not statistically significant (P gt ; 0.05). Conclusion Preoperative give EA pretreatment disorder incidence of anesthesia, cardiopulmonary bypass coronary artery bypass surgery and heart valve replacement surgery in patients with early cognitive function was not significantly affected.
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