超声引导下连续椎旁神经阻滞复合全麻对开胸手术患者治疗效果的影响

Effect of Ultrasound-guided Continuous Paravertebral Nerve Block Combined with General Anesthesia on Treatment of Open Thoracic Surgery

目的探讨超声引导下连续椎旁神经阻滞(CTPVB)复合全麻对开胸手术患者治疗效果的影响。方法选取2016年5月至2018年5月本院收治的80例开胸手术患者,随机分为A组和B组,每组40例。A组实施超声引导下连续胸椎旁神经阻滞复合全身麻醉方案,B组单纯实施全身麻醉,观察比较两组的治疗情况。结果两组患者在麻醉前血浆炎性因子白细胞介素6(IL-6)和白细胞介素10(IL-10)及肿瘤坏死因子-α(TNF-α)比较差异无统计学意义(P> 0.05)。麻醉后两组患者的IL-6和IL-10及TNF-α均有明显上升的现象,但A组IL-6和TNF-α明显低于B组,IL-10明显高于B组,差异有统计学意义(P <0.05)。同时A组患者在手术后的12、24、48 h的镇痛效果评分明显低于B组,差异有统计学意义(P <0.05)。A组的满意率(87.50%)高于B组(55.00%,P> 0.05)。结论在进行开胸手术时采用超声引导下CTPVB复合全麻方案,可以明显改善镇痛效果评分,减轻患者的炎症反应,促进患者手术后的康复。

Objective To investigate the effect of ultrasound-guided continuous paravertebral nerve block(CTPVB)combined with general anesthesia on the treatment of patients undergoing thoracotomy.Methods Eighty cases of open thoracic surgery patients admitted to our hospital from May 2016 to May 2018 were randomly divided into group A and group B,with 40 cases in each group.Group A was treated with continuous paravertebral nerve block combined with general anesthesia under the guidance of ultrasound;group B was treated with general anesthesia alone,and the treatment conditions of the two groups were observed and compared.Results There was no significant difference in plasma levels of interleukin-6(IL-6),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)between the two groups before anesthesia(P>0.05).After anesthesia,IL-6,IL-10 and TNF-αwere significantly increased in both groups.However,IL-6 and TNF-αin group A were significantly lower than those in group B,and IL-10 was significantly higher than that in group B(P<0.05).The analgesic effect of group A was significantly lower than that of group B at 12,24 and 48 hours after operation(P<0.05).The satisfaction rate of group A(87.50%)was higher than that of group B(55.00%)with statistical significance(P>0.05).Conclusion The combination of ultrasound-guided CTPVB and general anesthesia in thoracotomy can significantly improve the analgesic score,reduce the inflammatory response of patients and promote the recovery of patients after surgery.