| 鲁利峰,孟海兵,来 伟,丁国友,肖 容,鄢赛阳,程 乐,王信磊.超声引导腹横肌平面阻滞对开腹胃癌根治术患者循环应激、炎症因子及术后镇痛的影响[J].,2019,19(12):2357-2361 |
| 超声引导腹横肌平面阻滞对开腹胃癌根治术患者循环应激、炎症因子及术后镇痛的影响 |
| Effect of Ultrasound Guided Horizontal Block of Transabdominal Transverse Muscle on Circulatory Stress, inflammatory Factors and Postoperative Analgesia in Patients Undergoing Open Radical Gastrectomy for Gastric Cancer |
| 投稿时间：2018-12-23 修订日期：2019-01-18 |
| DOI：10.13241/j.cnki.pmb.2019.12.034 |
| 中文关键词: 开腹胃癌根治术 超声引导腹横肌平面阻滞 循环应激 炎症因子 镇痛 |
| 英文关键词: Open radical gastrectomy for gastric cancer Ultrasound guided horizontal block of transabdominal transverse muscle Cyclic stress Inflammatory factors Analgesia |
| 基金项目:江西省自然科学基金项目(2013NA127) |
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| 中文摘要: |
| 摘要 目的：探讨超声引导腹横肌平面阻滞对开腹胃癌根治术患者循环应激、炎症因子及术后镇痛的影响。方法：选择2015年12月至2017年12月我院接诊的95例择期行胃癌根治术的患者作为本研究对象，通过随机数表法分为观察组（n=48）和对照组（n=47），对照组给予全凭静脉麻醉，观察组在对照组基础上，联合超声引导腹横肌平面阻滞。比较两组不同时间点循环应激、炎症因子、镇痛情况和不良反应。结果：观察组切皮后5 min（T2）、切皮后30 min（T3）、术毕（T4）时点收缩压（SBP）、舒张压（DBP）、心率（HR）均明显低于对照组（P＜0.05）；观察组在术后1 h（T5）、术后12 h（T6）、术后24 h（T7）、术后48 h（T8）时点血清肿瘤坏死因子（TNF）-α、白介素（IL）-6均明显比对照组低（P＜0.05）；且观察组在T5、T6、T7、T8时点视觉模拟评分法（VAS）评分均明显低于对照组（P＜0.05）；观察组术后24 h舒芬太尼用量和镇痛泵按压次数均明显少于对照组[（73.45±8.40）μg vs（94.52±12.94）μg，（3.45±0.30）次vs（7.23±0.76）次]（P＜0.05）；两组不良反应总发生率分别为4.17%（2/48）、17.02%（9/47），差异具有统计学意义（P＜0.05）。结论：在开腹胃癌根治术中使用超声引导腹横肌平面阻滞效果显著，可减轻术中循环应激和术后炎症反应，且镇痛效果满意，安全性高，值得应用推广。 |
| 英文摘要: |
| ABSTRACT Objective: To study the effect of ultrasound guided horizontal block of transabdominal transverse muscle on circulatory stress, inflammatory factors and postoperative analgesia in patients undergoing open radical gastrectomy for gastric cancer. Methods: 95 patients of undergoing open radical gastrectomy for gastric cancer who received therapy from December 2015 to December 2017 in our hospital were selected as research objects, according to random number table, those patients were divided into the observation group (n=42) and the control group (n=48), the control group was given total intravenous anesthesia, and the observation group was guided by the ultrasound guided horizontal block of transabdominal transverse muscle on the basis of the control group. The cyclic stress, inflammatory factors, analgesia at different time points and adverse reactions were compared between the two groups at different time points. Results: The systolic pressure (SBP), diastolic pressure (DBP) and heart rate (HR) at after skin cutting 5min (T2), after skin cutting 30 min (T3) and end of operation (T4) in the observation group were significantly lower than that of the the control group(P＜0.05); the serum tumor necrosis factor (TNF)-α and interleukins (IL) -6 at postoperative 1 h (T5), postoperative 12 h (T6), postoperative 24 h (T7) and postoperative 48 h (T8) in the observation group were lower than that of the control group(P＜0.05); the scores of visual analogue scale (VAS) at T5, T6, T7 and T8 in the observation group were lower than that of the control group(P＜0.05); the postoperative 24 h sufentanil dosage and press times of analgesic pump in the observation group were less than that of the control group[（73.45±8.40）μg vs（94.52±12.94）μg，（3.45±0.30）timevs（7.23±0.76）time](P＜0.05); the total incidence of adverse reactions in the two groups was 4.17%（2/48）and17.02%（9/47） respectively, and there was significant difference(P＜0.05). Conclusion: Ultrasound guided horizontal block of transabdominal transverse muscle is well for open radical gastrectomy for gastric cancer, which can effectively reduce intraoperative cyclic stress and postoperative inflammatory reaction, and has satisfactory analgesic effect and high safety, it's worthy of application and promotion. |
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