胸椎旁神经阻滞对肺癌患者术后谵妄及认知功能的影响

Effect of thoracic paravertebral nerve block on postoperative delirium and cognitive function in patients with lung cancer

目的胸椎旁神经阻滞对肺癌患者根治术后谵妄及认知功能的影响。方法本研究对象为我院2019年1月~2021年1月招募的88例肺癌患者,均采用肺癌根治手术,数字表法将患者随机分为两组,对照组采用常规全麻,观察组在对照组基础上给予胸椎旁神经阻滞。比较两组患者术后12h、1d、3d疼痛视觉模拟评分(VAS)和简易智能精神状态评分(MMSE),并记录术后谵妄及认知功能障碍发生情况。结果相比于对照组,观察组术后12h、1d、3d VAS评分和谵妄、认知功能障碍发生率显著降低(P<0.05),而MMSE评分均显著升高(P<0.05);观察组显著低于对照组(P<0.05)。结论常规全麻联合胸椎旁神经阻滞能够显著提升肺癌患者根治术后镇痛效果,降低术后认知功能障碍、谵妄等精神类并发症的发生率。

Objective To study the effect of thoracic paravertebral nerve block on delirium and cognitive function after radical resection of lung cancer.Methods Eighty-eight patients with lung cancer in our hospital were recruited from January 2019 to January 2021 as the study subjects,all of whom underwent radical surgery for lung cancer.They were randomly divided into two groups using the number table method.The control group was given conventional general anesthesia;the observation group was given thoracic paravertebral nerve block on the basis of the control group.The two groups of patients with the visual analogue scale of pain(VAS)and simple mental state score(MMSE)at 12h,1d,and 3d after operation were compared.The occurrence of cognitive dysfunction during hospitalization were recorded.Results Compared to the control group,The 12h,1d and 3d VAS scores and the incidence of delirium and cognitive dysfunction of the observation group were significantly lower(P<0.05),while the 12h,1d,and 3d MMSE scores of the observation group were significantly higher(P<0.05).Conclusion Routine general anesthesia combined with thoracic paraspinal nerve block could improve the analgesic effect after radical resection of lung cancer and reduce the incidence of postoperative cognitive dysfunction,delirium and other mental complications.