腰方肌阻滞联合全身麻醉对中老年女性妇科肿瘤经腹腔镜手术患者术后早期认知功能的影响

Effect of Lumbar Quadratus Block Combined with General Anesthesia on Early Postoperative Cognitive Function in Middle-aged and Elderly Women Undergoing Laparoscopic Surgery for Gynecological Tumors

目的 探究分析腰方肌阻滞联合全身麻醉对中老年女性妇科肿瘤经腹腔镜手术患者术后早期认知功能的影响。方法 选取2021年6月—2022年9月经新沂市人民医院进行妇科肿瘤腹腔镜手术治疗的中老年患者86例为研究对象,根据随机数表法分为两组,各43例。对照组实施全身麻醉,研究组实施腰方肌阻滞联合全身麻醉。比较分析两组患者的血流动力学指标、术后疼痛情况和认知功能水平、不良反应发生情况。结果 切皮后5 min,研究组平均动脉压和心率均低于对照组,差异有统计学意义(P<0.05)。研究组在术后6、12 h时的VAS评分均低于对照组,差异有统计学意义(P<0.05)。研究组在术后1、3 d的简易智力状态检查量表评分均高于对照组,差异有统计学意义(P<0.05)。研究组的不良反应发生率为11.63%与对照组的13.95%比较,差异无统计学意义(χ^(2)=0.104,P>0.05)。结论 针对中老年女性妇科肿瘤经腹腔镜手术患者,采用腰方肌阻滞联合全身麻醉可稳定基本生命体征,降低术后疼痛,提升早期认知功能,安全性良好。

Objective To explore and analyze the effect of lumbar quadratus block combined with general anesthesia on early postoperative cognitive function of middle-aged and elderly female patients with gynecological tumor undergo‐ing laparoscopic surgery.Methods From June 2021 to September 2022,86 middle-aged and elderly patients who un‐derwent gynecological tumor Laparoscopy in Xinyi People´s Hospital were selected as the research objects.According to the random number table,they were divided into two groups,43 cases in each group.The control group received general anesthesia,while the study group received Quadratus lumborum muscle block combined with general anesthe‐sia.Compared and analyzed the hemodynamic indicators,postoperative pain and cognitive function levels,and inci‐dence of adverse reactions between the two groups of patients.Results Five minutes after skin incision,the mean arte‐rial pressure and heart rate in the study group were lower than those in the control group,and the difference was statis‐tically significant(P<0.05).The VAS scores of the study group were lower than those of the control group at 6 and 12 hours after surgery,the difference was statistically significant(P<0.05).The MMSE scores of the study group were higher than those of the control group on the 1st and 3rd day after surgery,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the study group was 11.63%,and there was no statistically significant difference compared to the 13.95%in the control group(χ^(2)=0.104,P>0.05).Conclusion For middle-aged and elderly female patients with gynecological tumors undergoing laparoscopic surgery,lumbar quadratus block combined with general anesthesia can stabilize the basic vital signs,reduce postoperative pain,improve early cognitive function,with good safety.