摘要
目的探讨超声引导下椎旁神经阻滞与全身麻醉联合用于胸腔镜下肺癌根治术治疗老年患者的效果。方法选取2018年4月-2019年4月入院择期行胸腔镜下肺癌根治术治疗的64例老年肺癌患者分为两组,全麻组(n=32)行气管插管全身麻醉,复合组(n=32)行超声下椎旁神经阻滞联合全麻,观察患者术后疼痛、认知功能、并发症发生情况等。结果术后6 h、12 h、24 h、48 h,复合组VAS评分相比全麻组均显著更低(t=7.585、9.420、5.356、7.086,P<0.05);术后1 h、6 h、24 h时复合组MMSE评分均显著高于全麻组(t=5.202、4.850、5.139,P<0.05);复合组患者术后自主呼吸恢复、呼之睁眼、吞咽平均时间均显著短于全麻组(t=17.465、24.759、26.513,P<0.05);复合组并发症总发生率为9.38%,相比参照组的31.25%显著更低(χ^2=4.730,P<0.05)。结论给予老年患者胸腔镜下肺癌根治术治疗时,选用超声引导下椎旁神经阻滞联合全麻方案,可获得更理想镇痛效果,使患者术后认知功能受到更小影响,且术后并发症更少,有助于改善患者预后。
Objective To evaluate the effect of ultrasound-guided paravertebral nerve block combined with general anesthesia in thoracoscopic radical resection of lung cancer in elderly patients.Methods Sixty-four elderly patients with lung cancer who were admitted to hospital from April 2018 to April 2019 for thoracoscopic radical resection of lung cancer were divided into two groups.The general anesthesia group(n=32)received general anesthesia with tracheal intubation,and the compound group(n=32)received ultrasound-assisted paravertebral nerve block combined with general anesthesia.Results The VAS score of the composite group was significantly lower than that of the general anesthesia group at 6,12,24 and 48 hours after operation(t=7.585,9.420,5.356,7.086,P<0.05).The MMSE score of the compound group was significantly higher than that of the general anesthesia group at 1,6 and 24 hours after operation(t=5.202,4.850,5.139,P<0.05).The mean time of spontaneous breathing recovery,eye opening and swallowing in the compound group was significantly shorter than that in the general anesthesia group(t=17.465,24.759,26.513,P<0.05).The total incidence of complications in the composite group was 9.38%,which was significantly lower than that in the control group(31.25%)(χ^2=4.730,P<0.05).Conclusion Ultrasound-guided paravertebral nerve block combined with general anesthesia for thoracoscopic radical resection of lung cancer in elderly patients can obtain better analgesic effect,make the cognitive function of patients less affected,and have fewer complications after operation,which is helpful to improve the prognosis of patients.
作者
陈静
郝在军
都义日
CHEN Jing;HAO Zai-jun;DU Yi-ri(Department of Anesthesiology of Inner Mongolia Ordos Central Hospital,Inner Mongolia 017000,China;Department of Anesthesiology of Affiliated Hospital of Inner Mongolia Medical University,Huhhot,Inner Mongolia 010050,China)
出处
《临床肺科杂志》
2020年第2期183-186,共4页
Journal of Clinical Pulmonary Medicine
基金
2017年度自治区卫生计划科研计划项目(No.201701071)
关键词
肺癌根治术
麻醉
神经阻滞
认知功能
并发症
radical resection of lung cancer
anesthesia
nerve block
cognitive function
complication
