单点胸椎旁神经阻滞用于乳腺癌改良根治术的临床研究

Clinical Study of Single Thoracic Paravertebral Block for Modified Radical Mastectomy for Breast Cancer

目的单点胸椎旁神经阻滞用于乳腺癌改良根治术对患者围手术期血流动力学及术后镇痛的临床影响。方法选取乳腺癌改良根治术女性患者250例,且病例数为每年50例。据随机数字法并按照是否联合超声引导单点胸椎旁神经阻滞将患者分为2组:对照组(125例),仅行全身麻醉;试验组(125例),行全身麻醉联合超声引导下单点胸椎旁神经阻滞。对比2组患者围手术期血流动力学及术后的镇痛情况。结果术后1、12 h试验组VAS评分均高于对照组,差异有统计学意义(P <0. 05)。在术后1、12、24、48 h,试验组的镇静情况均优于对照组,2组对比差异有统计学意义(P <0. 05)。诱导后2组患者在T2、T3时的HR、DBP、SBP的差异有统计学意义(P <0. 05)。诱导后2组患者的HR、DBP、SBP均有明显下降,对照组T2、T1时的HR、DBP、SBP差异有统计学意义(P <0. 05)。结论应用超声引导单点胸椎旁神经阻滞能取得更好的术后镇痛效果,且能有效降低手术风险,加速患者的术后康复。

Objective To study anesthesia combined with ultrasound guided single thoracic paravertebral block resection and surgery on hemodynamics in patients with breast cancer after modified analgesia. Methods 250 cases of female patients treated with breast modified radical mastectomy were selected,and the number of cases was 50 cases per year. According to the method of random number and according to whether the combined ultrasound guided single thoracic paravertebral block patients were divided into 2 groups: the control group( 125 cases) and the experimental group( 125 cases). Comparing the 2 groups of patients with postoperative analgesia and hemodynamics. Results After operation,the score of VAS in 1 and 12 h observation group was higher than that of the control group,the difference was statistically significant( P < 0. 05). After 1,12,24,48 h,the sedation of the test group was better than that of the control group,and the difference between the 2 groups was statistically significant( P <0. 05). The differences of HR,DBP and SBP in the 2 groups of patients at T2 and T3 were statistically significant( P < 0. 05).After induction,the HR,DBP and SBP of the 2 groups were significantly decreased. The contrast of HR,DBP and SBP in the control group compared with T2 and T1 were statistically significant( P < 0. 05). Conclusion Ultrasound guided single point paravertebral nerve block can get better postoperative analgesic effect,and can effectively reduce the risk of operation and accelerate the postoperative rehabilitation.