改良胸部神经阻滞结合全身麻醉对乳腺癌根治术患者血流动力学参数及并发症的影响研究

Effect of modified thoracic nerve block combined with general anesthesia on blood flow parameters and complications in patients undergoing radical mastectomy of breast cancer

目的研究改良胸部神经阻滞结合全身麻醉对乳腺癌根治术患者血流动力学参数及并发症的影响。方法选取2018年2月至2020年12月在广东医科大学附属第二医院进行乳腺癌根治术的80例患者,并采用随机数字表法将其分为常规组和研究组,各40例。常规组采用全身麻醉方案,而研究组采用改良胸部神经阻滞结合全身麻醉方案,比较两组麻醉前(T_(0))、插管前(T_(1))、插管时(T_(2))、拔管时(T_(3))的血流动力学参数,术中舒芬太尼用量、苏醒时间以及并发症发生情况。结果在T_(1)、T_(2)和T_(3),研究组患者的舒张压、收缩压、心率的波动幅度均小于常规组(P<0.05);同时,研究组患者术中舒芬太尼少于常规组,其苏醒时间短于常规组(P<0.05);且研究组的并发症发生率(5.00%)低于常规组(20.00%)(P<0.05)。结论在乳腺癌根治术中采用改良胸部神经阻滞结合全身麻醉,能有效稳定患者的血流动力学参数,减少其术中舒芬太尼,缩短苏醒时间,降低并发症发生率。

Objective To investigate the effects of modified thoracic nerve block combined with general anesthesia on blood flow parameters and complications in patients undergoing radical mastectomy of breast cancer.Method A total of 80 patients undergoing radical mastectomy of breast cancer in our hospital from February 2018 to December 2020 were selected as the research subjects,and they were divided into routine group and study group by random number table method,with 40 cases in each group.The conventional group was treated with general anesthesia,while the study group was treated with modified thoracic nerve block combined with general anesthesia.The hemodynamic parameters,intraoperative sufentanil dosage,time of recovery and incidence of complications were compared between the two groups at before anesthesia(T_(0)),before intubation(T_(1)),during intubation(T_(2))and extubation(T_(3)).Result At T_(1),T_(2) and T_(3),the fluctuation range of diastolic blood pressure,systolic blood pressure and heart rate in the study group were lower than those in the control group(P<0.05).Meanwhile,the recovery time of sufentanil in the study group was shorter than that in the conventional group(P<0.05).The incidence of complications in the study group(5.00%)was lower than that in the conventional group(20.00%)(P<0.05).Conclusion Modified chest nerve block combined with general anesthesia in radical mastectomy of breast cancer can effectively stabilize the hemodynamic parameters of patients,reduce their intraoperative sufentanil,shorten the recovery time and reduce the incidence of complications.