胸椎旁神经阻滞麻醉对肺叶切除术患者血糖及术后认知功能的影响

Effect of thoracic paravertebral nerve block anesthesia on blood glucose and postoperative cognitive function in patients with lobectomy

目的:分析在肺叶切除术患者中实施超声引导下胸椎旁神经阻滞麻醉对血糖的影响,并观察术后认知功能。方法:选择2017年4月—2019年1月实施肺叶切除术、麻醉方式为全身麻醉的患者56例,按入院先后顺序分为两组,每组28例。A组采用常规全身麻醉,B组采用超声引导下胸椎旁阻滞复合全麻。评估分析两组患者术前及术后不同时间段血糖指标、认知功能评分及脂联素水平。结果:56例患者术后6~48 h血糖较注药前均有升高,但A组患者血糖水平高于B组,差异有统计学意义(P<0.05)。A组术后24 h认知功能评分低于B组,差异有统计学意义(P<0.05)。而注药前及术后48 h患者认知功能评分比较,差异无统计学意义(P>0.05)。B组麻醉后脂联素水平高于A组,差异有统计学意义(P<0.05)。结论:对于实施肺叶切除术的患者,予以超声引导下胸椎旁神经阻滞麻醉对患者血糖影响较小,术后认知功能恢复迅速。

Objective:To analyze the effect of ultrasound-guided thoracic paravertebral nerve block anesthesia on blood glucose in patients with lobectomy,and to observe their postoperative cognitive function.Methods:All 56 cases were randomly selected from April 2017 to January 2019,implementation of lung resection between anesthesia for general anesthesia,group A of 28 patients will ultrasound guided by thoracic nerve block anesthesia induction of general anesthesia for the former,group B is the implementation of epidural block anesthesia.Evaluation and analysis of blood glucose indexes,cognitive function scores and adiponectin levels in two groups of patients before and after operation.Results:The blood glucose of 56 patients after 6~48 h was higher than that before injection,but the index level of group A patients was higher than that of group B,the difference was statistically significant(P<0.05).The cognitive func-tion score of group A after 24 hours was lower than that of group B,the difference was statistically significant(P<0.05).However,there was no statistically significant difference in the cognitive function scores of patients before and 48 hours after injection(P>0.05).The level of adiponectin in group B was higher than that in group A after anesthesia,the difference was statistically significant(P<0.05).Conclusion:For patients undergoing lobectomy,ultrasound-guided parathoracic nerve block anesthesia has little effect on the patient′s blood glucose,and postoperative cognitive function recovers quickly.