| 易勤美,杨坤渹,徐兆洋,黄蕴哲,张启荣.竖脊肌平面阻滞联合纳布啡超前镇痛对胸腔镜下肺癌根治术患者镇痛效果、免疫应激和认知功能的影响[J].,2024,(16):3171-3175 |
| 竖脊肌平面阻滞联合纳布啡超前镇痛对胸腔镜下肺癌根治术患者镇痛效果、免疫应激和认知功能的影响 |
| Effects of Erector Spinae Plane Block Combined with Nalbuphine Preemptive Analgesia on Analgesic Effect, Immune Stress and Cognitive Function in Patients Undergoing Thoracoscopic Radical Resection of Lung Cancer |
| 投稿时间：2024-02-04 修订日期：2024-02-28 |
| DOI：10.13241/j.cnki.pmb.2024.16.034 |
| 中文关键词: 竖脊肌平面阻滞 纳布啡 超前镇痛 肺癌根治术 镇痛效果 免疫应激 认知功能 |
| 英文关键词: Erector spinae plane block Nalbuphine Preemptive analgesia Radical resection of lung cancer Analgesic effect Immune stress Cognitive function |
| 基金项目:湖北省卫生和计划生育委员会科研项目（WJ2017F124） |
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| 中文摘要: |
| 摘要 目的：探讨胸腔镜下肺癌根治术患者采用竖脊肌平面阻滞（ESPB）联合纳布啡超前镇痛后，其镇痛效果、免疫应激、认知功能的变化情况。方法：按照随机数字表法将124例胸腔镜下肺癌根治术患者分为对照组（62例，ESPB）和研究组（62例，ESPB联合纳布啡超前镇痛）。对比两组术后镇痛泵按压次数、疼痛评分、血流动力学指标、细胞免疫功能指标、应激反应指标、认知功能评分变化情况。结果：研究组的术后镇痛泵按压次数少于对照组（P<0.05）。术后6 h、12 h、24 h、48 h，研究组疼痛视觉模拟（VAS）评分低于对照组（P<0.05）。研究组置管后、切片时、拔管后心率（HR）、平均动脉压（MAP）高于对照组（P<0.05）。研究组术后24 h CD3+、CD4+、CD4+/CD8+高于对照组，CD8+、去甲肾上腺素（NE）和肾上腺素（E）低于对照组（P<0.05）。研究组术后24 h、术后48 h、术后7 d简易智能精神状态检查量表（MMSE）评分高于对照组（P<0.05）。结论：胸腔镜下肺癌根治术患者采用ESPB联合纳布啡超前镇痛，可发挥良好的镇痛效果，稳定机体血流动力学，减轻免疫应激以及对认知功能的影响。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the changes of analgesic effect, immune stress and cognitive function after preemptive analgesia with erector spinae plane block (ESPB) combined with nalbuphine in patients undergoing thoracoscopic radical resection of lung cancer. Methods: 124 patients undergoing thoracoscopic radical resection of lung cancer were divided into control group (62 cases, ESPB) and study group (62 cases, ESPB combined with nalbuphine preemptive analgesia) according to the random number table method.The changes of postoperative analgesia pump pressing times, pain score, hemodynamic index, cellular immune function index, stress response index and cognitive function score were compared between two groups. Results: The number of postoperative analgesia pump pressing in study group was less than that in control group(P<0.05). 6 h, 12 h, 24 h and 48 h postoperative, visual analogue scale (VAS) scores of pain in study group were lower than those in control group (P<0.05). The heart rate (HR) and mean arterial pressure (MAP) after catheterization, slicing and after extubation in study group were higher than those in control group(P<0.05). The levels of CD3+, CD4+ and CD4+/CD8+ in study group were higher than those in control group at 24 h postoperative, CD8+, norepinephrine(NE) and epinephrine (E) in study group were lower than those in control group (P<0.05). The scores of mini-mental state examination (MMSE) in study group were higher than those in control group at 24 h, 48 h and 7 d postoperative(P<0.05). Conclusion: ESPB combined with nalbuphine for preemptive analgesia in patients undergoing thoracoscopic radical resection of lung cancer, which can exert good analgesic effect, stabilize hemodynamics, reduce immune stress and affect cognitive function. |
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