超声引导椎旁神经阻滞麻醉对肺癌患者的麻醉效果及应激反应、血流动力学的影响

doi:10.3969/j.issn.1671-7171.2020.10.011

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摘要 【目的】 观察超声引导椎旁神经阻滞麻醉对肺癌患者的麻醉效果及应激指标、血流动力学的影响。【方法】 在本院接受手术治疗的肺癌100例,根据其麻醉方式的不同分为两组,观察组给予超声引导椎旁神经阻滞麻醉,对照组给予全身麻醉。比较两组患者麻醉效果,围手术期血流动力学、应激指标、免疫功能的差异。【结果】 观察组患者术后4 h和术后12 h视觉模拟评分(VAS)明显低于对照组(P<0.01),两组患者术后Ramsay评分相比较差异无显著性(P>0.05);两组患者麻醉前血流动力学、应激指标、免疫功能指标相比较差异无显著性(P>0.05)。术后4 h,观察组患者的收缩压(SBP)、平均动脉压(MAP)、心率(HR)水平及皮质醇、肿瘤坏死因子-α(TNF-α)水平低于对照组(P<0.05);观察组患者的CD4⁺、CD8⁺ 水平高于对照组(P<0.05)。【结论】 超声引导椎旁神经阻滞麻醉对肺癌患者的麻醉效果较好,且对血流动力学、免疫功能影响小,具有良好的应用价值。

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	李春芳
	成龙

关键词 ：肺肿瘤, 神经传导阻滞/方法, 麻醉

Abstract：【Objective】 To observe the effect of ultrasound-guided paravertebral nerve block anesthesia on lung cancer patients and its influence on stress index and hemodynamics. 【Methods】 One hundred Patients with lung cancer who underwent surgery from May 2016 to May 2018 in our hospital were selected as the study subjects. According to the different anesthetic methods, the patients in the observation group were given ultrasound-guided paravertebral nerve block anesthesia and patients in the control group received general anesthesia. The effects of anesthesia were observed and the differences of hemodynamics, stress index and immune function were compared between the two groups.【Results】 The Visual simulation (VAS)scores of the patients at both 4h and 12 h after surgery in the observation group were lower than those in the control group ( P<0.05). There was no significant difference in Ramsay scores between the two groups (P>0.05). There was no difference in hemodynamic parameters, immune function and stress index between the two groups before anesthesia. The levels of SBP,MAP,HR and cortisol , TNF-α in the observation group at 4 hours after anesthesia were lower than those in the control group ( P<0.05). At 4 hours after operation, the levels of CD4⁺ and CD8⁺ in the observation group were higher than those in the control group (P<0.05).【Conclusion】 Ultrasound-guided paravertebral nerve block anesthesia has a good anesthetic effect for lung cancer patients, and has little effect on hemodynamics and immune function. It has a good application value.

Key words： Lung Neoplasms Nerve Block/MT Anesthesia

收稿日期: 2019-04-11

PACS:

R734.2

基金资助:2017年四川省卫生和计划生育委员会科研课题 (编号:17PJ231 )

引用本文:

李春芳, 成龙. 超声引导椎旁神经阻滞麻醉对肺癌患者的麻醉效果及应激反应、血流动力学的影响[J]. 医学临床研究, 2020, 37(10): 1477-1479.
LI Chun-fang, CHENG Long. Effect of Ultrasound-guided Paravertebral Nerve Block Anesthesia on Stress Response and Hemodynamics in Patients with Lung Cancer. JOURNAL OF CLINICAL RESEARCH, 2020, 37(10): 1477-1479.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2020.10.011 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2020/V37/I10/1477