医学临床研究
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医学临床研究  2019, Vol. 36 Issue (6): 1090-1092    DOI: 10.3969/j.issn.1671-7171.2019.06.017
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超声引导下PVB在PCNL手术中的应用效果及对患者炎症应激反应的影响
彭洪, 郑东, 刘洪
四川省达州市中西医结合医院超声科,四川 达州 635000
Ultrasound-guided PVB in PCNL Surgery and its Effect on Inflammatory Stress Response
PENG Hong, ZHEN Dong, LIU Hong
Department of Ultrasound, Dazhou Integrated Hospital of Traditional Chinese and Western Medicine, Dazhou, Sichuan 635000
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摘要 【目的】探讨超声引导下椎旁神经阻滞麻醉(PVB)在经皮肾镜取石术(PCNL)术中的应用效果及对患者炎症应激反应的影响。【方法】拟实施PCNL手术的120例肾结石患者,随机分为PVB组(超声引导下PVB)、全麻组(全身麻醉),各60例。比较两组患者麻醉前(T0)、麻醉后10 min(T1)、建立碎石通道后(T2)、碎石术中(T3)、术毕(T4)患者的心率(HR)、平均动脉压(MAP);患者术前、术后24 h的血清白细胞介素-6(IL-6)、IL-10、肿瘤坏死因子-α(TNF-α)、皮质醇变化;比较两组患者术后24 h舒芬太尼用量、自控静脉镇痛(PCIA)泵按压次数。【结果】T0时两组的各项指标比较差异无显著性(P>0.05);T1、T2时PVB组的HR值低于全麻组,MAP值高于全麻组(P<0.05);术后24 h,PVB组的血清IL-6、TNF-α、皮质醇低于全麻组,IL-10高于全麻组(P<0.05);在术后24 h,PVB组的舒芬太尼用量、PCIA泵按压次数低于全麻组(P<0.05)。【结论】超声引导下PVB在PCNL术中应用有利于维持患者血流动力学稳定、减轻手术引起的炎症应激反应、减少术后舒芬太尼用量及PCIA按压次数。
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彭洪
郑东
刘洪
关键词 神经传导阻滞肾结石/外科学肾造口术经皮    
Abstract【Objective】To investigate the effect of ultrasound-guided paravertebral nerve block anesthesia (PVB) in percutaneous nephrolithotomy (PCNL) and its effect on inflammatory stress response. 【Methods】 One hundred and twenty cases of renal calculi undergoing PCNL were randomly divided into PVB group (ultrasound-guided PVB) and general anesthesia group (general anesthesia), 60 cases each. Before anesthesia (T0), 10 minutes after anesthesia (T1), after establishment of lithotripsy channel (T2), during lithotripsy (T3), heart rate (HR) after operation (T4) and mean arterial pressure (MAP) were compared between the two groups. The changes of serum interleukin-6 (IL-6), IL-10, tumor necrosis factor-alpha (TNF-α) and cortisol before and 24 hours after operation were compared between the two groups.The dosage of sufentanil 24 hours after operation and the times of pressing by PCIA pump were compared between the two groups.【Results】 There was no significant difference between the two groups at T0 (P>0.05); HR value in PVB group was lower than that in the general anesthesia group at T1 and T2, and MAP value was higher than that in the general anesthesia group (P<0.05); serum IL-6, TNF-αand cortisol in the PVB group were lower than those in the general anesthesia group at 24h after operation, and IL-10 was higher than that in the general anesthesia group (P<0.05); sufentanil dosage and PCIA pump compression times in PVB group were lower than those in general anesthesia group at 24h after operation (P<0.05) 【Conclusion】Ultrasound-guided application of PVB in PCNL is conducive to maintaining hemodynamic stability, alleviating inflammatory stress induced by surgery, reducing sufentanil dosage and PCIA pressing times.
Key wordsNerve Block    Kidney Calculi/SU    Nephrostomy, Percutaneous
收稿日期: 2018-07-17     
PACS:  R692.4  
引用本文:   
彭洪, 郑东, 刘洪. 超声引导下PVB在PCNL手术中的应用效果及对患者炎症应激反应的影响[J]. 医学临床研究, 2019, 36(6): 1090-1092.
PENG Hong, ZHEN Dong, LIU Hong. Ultrasound-guided PVB in PCNL Surgery and its Effect on Inflammatory Stress Response. JOURNAL OF CLINICAL RESEARCH, 2019, 36(6): 1090-1092.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2019.06.017     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2019/V36/I6/1090
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