摘要
目的 探讨血清β-内啡肽、强啡肽水平与肾肿瘤椎旁神经阻滞镇痛效果的关系。方法 分析2020年1月至2022年4月在沧州市人民医院接受肾肿瘤手术的90例患者临床资料,根据镇痛方法不同分组,对照组(n=45)接受全身麻醉后手术,观察组(n=45)在全身麻醉前行椎旁神经阻滞,比较两组基本情况、血清指标及术后视觉模拟疼痛评分(VAS),分析血清β-内啡肽、强啡肽水平与肾肿瘤椎旁神经阻滞镇痛效果的关系。结果 两组性别、年龄、病程、体质指数、手术时间、术中出血量比较,差异无统计学意义(P>0.05)。与术后1 h比较,两组术后6h的VAS评分均明显降低,血清β-内啡肽(β-EP)和强啡肽(DYN)水平均明显升高;且观察组术后1 h、6 h的VAS评分均低于对照组,血清β-EP和DYN水平均高于对照组,差异有统计学意义(t=3.100、3.235、6.086、5.117、4.091、5.142,P<0.05)。Pearson相关性分析结果显示,血清β-EP、DYN水平与椎旁神经阻滞肾肿瘤术后VAS评分呈负相关(P<0.05)。结论 椎旁神经阻滞用于肾肿瘤手术的镇痛效果显著,且与血清β-EP、DYN水平密切相关。
Objective To investigate the relationship between serum β-endorphin and dynorphin levels and the analgesic effect of paraspinal nerve blockade for renal tumors. Methods The clinical data of 60patients who underwent renal tumor surgery in Cangzhou People ’s Hospital from January 2020 to April 2022were retrospectively analyzed. According to different methods of analgesia,the control group(n=45)received surgery after general anesthesia,and the observation group(n=45)received paravertebral nerve block before general anesthesia. The basic conditions,serum indicators and postoperative visual analog pain score(VAS)of the two groups were compared. The simulated pain score(VAS)was used to analyze the relationship between serum β-endorphin and dynorphin levels and the analgesic effect of renal tumor paraspinal nerve block. Results There were no significant differences in gender,age,disease duration,body mass index,operation time,and intraoperative blood loss between the two groups(P>0.05). Compared with 1 h after surgery,The VAS scores were significantly lower at 6 h after surgery in both groups,and serum β-Endophilin(β-EP)and dynorphin(dyn)levels were significantly increased. And the VAS scores in the observation group were lower than those in the control group at 1 and 6 h after surgery,and serum β-EP and dyn levels were higher than those in the control group,with statistically significant differences(t=3.100、3.235、6.086、5.117、4.091、5.142,P<0.05). Pearson correlation analysis showed that serum β-EP and dyn levels were negatively correlated with postoperative VAS scores in renal tumors treated with paravertebral nerve block(P<0.05). Conclusions Paravertebral nerve block has a significant analgesic effect in renal tumor surgery and is closely related to serum β-EP and DYN levels.
作者
徐倩
朱爱
郭岩松
王明丽
张慧玲
张爱荣
XU Qian;ZHU Ai;GUO Yansong;WANG Mingli;ZHANG Huiling;ZHANG Airong(Department of Anesthesiology,Cangzhou People's Hospital,Cangzhou,Hebei,China,061000)
出处
《分子诊断与治疗杂志》
2022年第10期1705-1708,共4页
Journal of Molecular Diagnostics and Therapy
基金
沧州市科技计划自筹经费项目(204106006)。
关键词
Β-内啡肽
强啡肽
肾肿瘤
椎旁神经阻滞
镇痛
β-Endorphins
Dynorphin
Renal tumors
Paravertebral nerve blocks
Analgesia
