| B超引导腹横肌平面阻滞对腹腔镜直肠癌根治术老年患者术后镇痛效果及免疫功能的影响 |
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| 引用本文： | 庞希友.B超引导腹横肌平面阻滞对腹腔镜直肠癌根治术老年患者术后镇痛效果及免疫功能的影响[J].中华全科医学,2017,15(7):1159-1162. |
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| 作者姓名： | 庞希友 |
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| 作者单位： | 金华市中心医院麻醉科, 浙江 金华 321000 |
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| 摘 要： | 目的 观察B超引导腹横肌平面阻滞应用于腹腔镜直肠癌根治术老年患者术后镇痛效果及对患者免疫功能的影响。 方法 将60例腹腔镜直肠癌根治术老年患者随机分为2组,腹横肌平面阻滞组于全麻诱导后行B超引导腹横肌平面阻滞,静注0.25%盐酸罗哌卡因30 ml;生理盐水对照组静注等容量生理盐水。观察2组麻醉前(T0)、术后1 h (T1)、术后12 h (T2)、术后24 h (T3)及术后48 h (T4)视觉模拟评分(VAS评分)及血流动力学指标;记录术后24 h镇痛泵按压次数及舒芬太尼使用总量;比较CD4+%、CD8+%、IFN-γ水平及不良反应。 结果 与生理盐水对照组比较,腹横肌平面阻滞组于T1、T2时点MAP降低,T1、T2及T3时点HR降低(均P<0.05)。与生理盐水对照组比较,腹横肌平面阻滞组于T1、T2、T3、T4时点VAS评分均更低,且术后24 h按压次数及舒芬太尼总量均降低(均P<0.05)。与生理盐水对照组比较,腹横肌平面阻滞组T1、T2、T3及T4时点CD4+%水平均升高,IFN-γ水平T2、T3时点均升高(均P<0.05)。与生理盐水对照组比较,腹横肌平面阻滞组不良反应发生率降低(P<0.05)。 结论 B超引导腹横肌平面阻滞应用于腹腔镜直肠癌根治术老年患者术后镇痛效果较佳,血流动力学平稳,且对免疫功能具有保护作用,不良反应发生率低。
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| 关 键 词： | B超 腹横肌平面阻滞 腹腔镜 直肠癌根治术 老年 免疫功能 |
| 收稿时间： | 2016-11-01 |
Influence of ultrasound guided transversus abdominis plane block on postoperative analgesic effect and immune function in elderly patients undergoing laparoscopic radical resection of rectal cancer |
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| Affiliation: | Department of Anesthesia, Jinhua Central Hospital, Jinhua, Zhejiang 321000, China |
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| Abstract: | Objective To observe the influence of ultrasound guided transversus abdominis plane block on postoperative analgesic effect and immune function in elderly patients undergoing laparoscopic radical resection of rectal cancer. Methods Sixty elderly patients undergoing laparoscopic radical resection of rectal cancer were randomly divided into observation group and control group.Ultrasound guided transversus abdominis plane block after general anesthesia induction was performed in the observation group (intravenous injection of 0.25% ropivacaine hydrochloride of 30 ml), while the control group received intravenous injection of equal volume saline.The visual analogue score (VAS score) and related parameters of hemodynamics were observed before anesthesia (T0), 1 h after operation (T1), 12 h after operation (T2), 24 h after operation (T3) and 48 h after operation (T4).Twenty-four hours analgesia pressing times and total postoperative sufentanil were recorded.CD4+%, CD8+% and IFN-γ levels and adverse reactions were compared between the two groups. Results Compared with the control group, MAP in the observation group decreased at T1 and T2, and HR decreased at T2 and T3 (P < 0.05).Compared with the control group, the VAS scores in the observation group were lower at T1, T2, T3 and T4;the postoperative 24 h pressing times and amount of sufentanil were decreased (P < 0.05).Compared with the control group, CD4+% levels in the observation group increased at T1, T2, T3 and T4, IFN-γ levels at T2 and T3 were higher (P < 0.05).Compared with the control group, the incidence of adverse reactions in the observation group was lower (P < 0.05). Conclusion Ultrasound guided transversus abdominis plane block used in laparoscopic radical resection of rectal cancer in elderly patients has better postoperative analgesic effect, stable hemodynamics and less postoperative pain, and it has protective effect on immune function and lower the incidence of adverse reactions. |
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