星状神经节阻滞联合全身麻醉复合硬膜外麻醉在胃癌根治术中的应用效果

Effect of stellate ganglion block combined with general anesthesia and epidural anesthesia in radical resection of gastric cancer

目的探讨星状神经节阻滞联合全身麻醉复合硬膜外麻醉在胃癌根治术中的应用效果。方法根据麻醉方式的不同将100例胃癌根治术患者分为对照组和观察组,每组50例,对照组患者给予全身麻醉复合硬膜外麻醉,观察组患者给予星状神经节阻滞联合全身麻醉复合硬膜外麻醉。比较两组患者胃肠功能恢复指标、疼痛程度、血流动力学指标及并发症发生情况。结果观察组患者首次排气时间、首次进食时间、住院时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。术后2、24、48 h,两组患者视觉模拟评分法(VAS)评分比较,差异均无统计学意义(P﹥0.05)。插管即刻(T1)、切皮即刻(T2)、手术1 h(T3)时,观察组患者收缩压、舒张压、心率均低于本组入室时(T0)时和对照组,差异均有统计学意义(P﹤0.05)。两组患者的并发症发生率比较,差异均无统计学意义(P﹥0.05)。结论星状神经节阻滞联合全身麻醉复合硬膜外麻醉能够抑制胃癌根治术患者的应激反应,维持血流动力学稳定,促进患者胃肠功能恢复,缩短住院时间。

Objective To explore the effect of stellate ganglion block combined with general anesthesia and epidural anesthesia in the radical operation of gastric cancer.Method A total of 100 patients undergoing radical gastrectomy for gastric cancer were divided into control group(n=50,received epidural and general anesthesia)and observation group(n=50,received stellate ganglion block+epidural and general anesthesia)according to anesthesia.The recovery indexes of gastrointestinal function,pain degree,hemodynamic indexes and complications of the two groups were compared.Result The first exhaust time,first food intake time and hospitalization time in the observation group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.01).There were no significant differences in visual analogue scale(VAS)scores between the two groups at 2,24 and 48 hours after operation(P>0.05).At the time of intubation(T1),skin incision(T2)and 1 hour of operation(T3),the systolic blood pressure,diastolic blood pressure and heart rate in the observation group were lower than those at the time of entry(T0)and the control group(P<0.05).There was no significant difference in the incidence of complication between the two groups(P>0.05).Conclusion Stellate ganglion block and general anesthesia and epidural anesthesia can inhibit the stress response of patients undergoing radical gastrectomy,maintain hemodynamic stability,promote the recovery of gastrointestinal function,and shorten hospital stay.