| 杜克信,高昌俊,李晓勤,李 芳,张静贻.全麻联合椎旁神经阻滞在胸腔镜下肺叶切除术中的麻醉效果及对术后认知功能和炎症反应的影响[J].,2022,(22):4361-4365 |
| 全麻联合椎旁神经阻滞在胸腔镜下肺叶切除术中的麻醉效果及对术后认知功能和炎症反应的影响 |
| Anesthesia Effect of General Anesthesia Combined with Paravertebral Nerve Block in Thoracoscopic Lobectomy and Its Effect on Postoperative Cognitive Function and Inflammatory Response |
| 投稿时间：2022-04-06 修订日期：2022-04-30 |
| DOI：10.13241/j.cnki.pmb.2022.22.031 |
| 中文关键词: 全身麻醉 椎旁神经阻滞 认知功能 炎症 |
| 英文关键词: General anesthesia Paraspinal nerve block Cognitive function Inflammation |
| 基金项目:陕西省科技厅一般项目-社会发展领域（2022SF-585） |
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| 摘要 目的：研究全身麻醉联合椎旁神经阻滞在胸腔镜下肺叶切除术患者的应用效果，探讨其对患者术后认知功能和炎 症反应的影响。方法：选取2017年-2021年在我院接受胸腔镜下肺叶切除术治疗的患者100例，根据其麻醉方式的不同分为对照组（50例）和研究组（50例），对照组给予全身麻醉，研究组给予全身麻醉联合椎旁神经阻滞。比较两组患者手术时间、麻醉时间、术中出血量、舒芬太尼和瑞芬太尼用量、术后疼痛情况、简易智力状态检查量表（MMSE）评分和血清C-反应蛋白（CRP）、白介素-6（IL-6）水平。结果：两组患者手术时间、麻醉时间和术中出血量比较无显著差异（P>0.05），而研究组患者舒芬太尼用量和瑞芬太尼用量均低于对照组（P<0.05）；研究组患者术后6、12、24和48小时疼痛评分均较对照组患者低（P<0.05）；两组患者术前MMSE评分无差异（P>0.05），研究组患者术后6、12、24和48小时MMSE评分均较对照组高（P<0.05）；两组患者术前血清CRP和IL-6水平无显著差异，但研究组患者术后24小时血清CRP和IL-6水平均显著低于对照组（P<0.05）。结论：全身麻醉联合椎旁神经阻滞用于胸腔镜下肺叶切除术患者可有效减少手术中麻醉药物用量，术后镇痛效果更好，对患者认知功能损伤更低，并且术后炎症更低。 |
| 英文摘要: |
| ABSTRACT Objective: To study the application effect of general anesthesia combined with paravertebral nerve block in patients undergoing thoracoscopic lobectomy, and to explore its effect on postoperative cognitive function and inflammatory response in patients. Methods: A total of 100 patients who received thoracoscopic lobectomy in our hospital from 2017 to 2021 were selected. According to the different anesthesia methods, they were divided into matched group (50 cases) and reserach group (50 cases). Patients in matched group were given general anesthesia, and patients in research group were given general anesthesia combined with paravertebral nerve block. We compared the operation time, anesthesia time, intraoperative blood loss, sufentanil and remifentanil dosage, postoperative pain, Mini-Mental State Examination (MMSE) score, and serum C-reactive protein (CRP) and interleukin-6 (IL-6) levels between the two groups. Results: There was no difference in operation time, anesthesia time and intraoperative blood loss between the two groups (P>0.05), while the dosages of sufentanil and remifentanil in the reserach group were lower than those in the matched group (P<0.05); the pain scores of the patients in the reserach group were significantly lower than those in the matched group at 6, 12, 24 and 48 hours after surgery (P<0.05); there was no difference in the preoperative MMSE scores between the two groups (P>0.05), the MMSE scores of patients in the reserach group were significantly higher than those in the matched group at 6, 12, 24 and 48 hours after surgery (P<0.05); There was no difference in serum CRP and IL-6 levels between the two groups before surgery, but the levels of serum CRP and IL-6 in the reserach group were lower than those in the matched group at 24 hours after operation (P<0.05). Conclusion: General anesthesia combined with paravertebral nerve block for patients undergoing thoracoscopic lobectomy can effectively reduce the amount of anesthesia drugs during surgery, have better postoperative analgesia, lower cognitive impairment and lower postoperative inflammation. |
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