摘要
目的探讨不同麻醉方式对甲状腺癌患者术后疼痛及免疫功能的影响。方法选择收治的180例甲状腺癌患者,根据随机数字表法,将所有患者分为3组,A组采用局部麻醉方式,B组采用静脉镇痛麻醉方式,C组采用颈丛神经阻滞麻醉方式。对比3组患者术后1 h、4 h、8 h、12 h、24 h的视觉模拟疼痛评分(VAS),对比3组患者的恶心呕吐、伤口愈合情况及3组术毕及术后1 d的CD4^+、CD8^+及CD4^+/CD8^+水平。结果 3组患者术后1 h的VAS评分对比无统计学差异(P> 0. 05),C组术后4 h、8 h、12 h、24 h时的VAS评分明显低于A、B组(P <0. 05),且A、B组间对比无统计学差异(P> 0. 05)。A组、B组的恶心呕吐发生率及伤口水肿、感染的发生率明显高于C组(P <0. 05)。术后1 d 3组患者的CD4^+、CD8^+、CD4^+/CD8^+水平均明显低于术毕,且C组的CD4^+、CD8^+、CD4^+/CD8^+水平明显高于A组及B组(P <0. 05)。结论颈丛神经阻滞可显著降低甲状腺联合根治术术后疼痛、不良反应,有利于术后免疫功能的恢复,值得临床推广应用。
Objective To investigate the influence of different anesthesia methods on postoperative pain and immune function in patients with thyroid cancer. Methods 180 cases with thyroid cancer were chosen and who divided to 3 groups according to the random number table method,group A were given local anesthesia mode,group B were given intravenous analgesia and anesthesia,group C were given anesthesia for cervical plexus block,the VAS score of three groups after surgery for 1 h,4 h,8 h,12 h,24 h were compared,the nausea,vomiting and wound healing,CD4^+,CD8^+and CD4^+/CD8^+of three groups after surgery for 1 d. Results There was no significant difference in VAS scores between the 3 groups( P > 0. 05). The VAS scores of the C group were significantly lower than those of the A and B groups at 4 h,8 h,12 h and 24 h after operation( P < 0. 05),and there was no statistical difference between the A and B groups( P > 0. 05). The incidence of nausea and vomiting and the incidence of wound edema and infection in the group A and group B were significantly higher than those of group C( P < 0. 05). The levels of CD4^+,CD8^+,CD4^+/CD8^+in the 3 groups were significantly lower than those of the 3 groups after operation,and the levels of CD4^+,CD8^+,CD4^+/CD8^+in group C were significantly lower than those of group A and B( P < 0. 05). Conclusion The cervical plexus block could significantly reduce pain and adverse reactions after radical thyroidectomy,which was beneficial to the recovery of postoperative immune function and it is worthy of clinical application.
作者
沈伟
徐威
钟江
SHEN Wei;XU Wei;ZHONG Jiang(Tinglin Hospital of Jinshan District,Shanghai,201505)
出处
《实用癌症杂志》
2020年第1期142-144,152,共4页
The Practical Journal of Cancer
关键词
麻醉方式
甲状腺癌
术后疼痛
免疫功能
颈丛神经阻滞
Anesthesia Methods
Thyroid cancer
Postoperative pain
Immune function
Cervical plexus block
