椎旁阻滞联合全身麻醉对结直肠癌切除术患者术后应激反应的影响

Effect of paravertebral block combined with general anesthesia on postoperative stress response in patients with colorectal cancer resection

目的探讨椎旁阻滞联合全身麻醉对结直肠癌切除术患者术后应激反应的影响。方法选取2016年5月~2018年5月我院收治的200例结直肠癌切除术患者作为研究对象,按照抽签分组方法将其分为观察组(100例)与对照组(100例)。观察组患者采用椎旁阻滞联合全身麻醉方法,对照组患者采用全身麻醉方法。比较两组患者的住院天数、拔管时间、视觉模拟量表(VAS)评分及皮质醇(Cor)、血管紧张素Ⅱ(AngⅡ)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平。结果观察组患者的住院天数[(10.12±0.11)d]、拔管时间[(5.01±3.01)h]均短于对照组[(12.21±3.15)d、(7.23±3.45)h],差异有统计学意义(P<0.05)。观察组患者的Cor[(241.52±43.25)pg/ml]、AngⅡ[(70.23±6.27)pg/ml]水平均低于对照组[(275.21±52.11)、(86.45±10.11)pg/ml],差异有统计学意义(P<0.05)。观察组患者的VAS评分为(2.01±0.45)分,低于对照组的(4.25±0.76)分,差异有统计学意义(P<0.05)。观察组患者的CRP[(37.15±9.21)mg/L]、TNF-α[(53.01±15.23)pg/ml]水平均低于对照组[(43.11±10.25)mg/L、(62.11±16.45)pg/ml],差异有统计学意义(P<0.05)。结论结直肠癌切除术患者实施椎旁阻滞联合全身麻醉后,能改善患者术后应激反应,降低疼痛感。

Objective To investigate the effect of paravertebral block combined with general anesthesia on postoperative stress response in patients with colorectal cancer resection.Methods A total of 200 patients with colorectal cancer resection admitted to our hospital from May 2016 to May 2018 were selected as the research objects.According to the method of drawing lots,they were divided into observation group(100 cases)and control group(100 cases).The observation group was given paravertebral block combined with general anesthesia,while the control group was given general anesthesia.The hospitalization stay,extubation time,visual analogue scale(VAS)score and the levels of cortisol(Cor),angiotensinⅡ(AngⅡ),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)were compared between the two groups.Results The hospitalization stay([10.12±0.11]d)and extubation time([5.01±3.01]h)in the observation group were shorter than those in the control group([12.21±3.15]d,[7.23±3.45]h),and the differences were statistically significant(P<0.05).The levels of Cor([241.52±43.25]pg/ml),AngⅡ([70.23±6.27]pg/ml)in the observation group were lower than those in the control group([275.21±52.11],[86.45±10.11]pg/ml),and the differences were statistically significant(P<0.05).The VAS score of the observation group was(2.01±0.45)points,which was lower than that of the control group for(4.25±0.76)points,and the difference was statistically significant(P<0.05).The levels of CRP([37.15±9.21]mg/L)and TNF-α([53.01±15.23]pg/ml)in the observation group were lower than those in the control group([43.11±10.25]mg/L,[62.11±16.45]pg/ml),and the differences were statistically significant(P<0.05).Conclusion Paravertebral block combined with general anesthesia can improve the stress response and reduce pain in patients undergoing colorectal cancer resection.