星状神经节阻滞对行腹腔镜直肠癌根治术老年患者术后认知功能的影响

The Effect of Stellate Ganglion Block on Postoperative Cognitive Function in Elderly Patients Undergoing Laparoscopic Radical Resection of Rectal Cancer

目的 探究星状神经节阻滞(SGB)对行腹腔镜直肠癌根治术老年患者术后认知功能的影响。方法 选取2022年4月至2023年4月在洛阳市中心医院择期行腹腔镜直肠癌除术的老年患者60例,随机分为对照组和研究组,各30例。研究组术前在超声引导下用0.3 75%罗哌卡因7ml行右侧SGB,对照组在相同部位注射相同剂量0.9%NACL溶液。比较两组患者术后恢复情况,记录患者各时段血流动力学、生化指标水平,并评估其认知功能。结果 研究组拔管时间短于对照组(P<0.05)。研究组患者T3~T5时段MAP、HR均低于对照组(P<0.05),T3~T5时段rSO2高于研究组(P<0.05)。研究组术后6h、24h的AngⅡ、Cor、IL-6、TNF-α、NSE、S100β均较对照组更低(P<0.05)。研究组患者术后24h、3d、1周的MMSE评分均较对照组更高(P<0.05)。结论 在腹腔镜直肠癌根治术中实施SGB,能有效维持老年患者血流动力学稳定,增加其脑氧含量,抑制机体应激与炎症反应,并保护其认知功能。

Objective To investigate the effect of stellate ganglion block(SGB)on postoperative cognitive function in elderly patients undergoing laparoscopic radical resection of rectal cancer.Methods Sixty elderly patients who underwent laparoscopic rectal cancer resection at Luoyang Central Hospital from April 2022 to April 2023 were randomly divided into a control group and a study group,with 30 patients in each group.The study group underwent right SGB with 7ml of 0.375%ropivacaine under ultrasound guidance before surgery,while the control group was injected with the same dose of 0.9%NACL solution at the same site.Compare the postoperative recovery of two groups of patients,record the levels of hemodynamics and biochemical indicators at each time period,and evaluate their cognitive function.Results The extubation time of the study group was shorter than that of the control group(P<0.05).The MAP and HR of the study group patients during the T3 to T5 period were lower than those of the control group(P<0.05),and the rSO2 during the T3 to T5 period was higher than that of the study group(P<0.05).Ang II,Cor,IL-6,TNF at 6h and 24h after surgery in the study group-α、NSE,S100βBoth were lower than the control group(P<0.05).The MMSE scores of the study group patients at 24 hours,3 days,and 1 week after surgery were higher than those of the control group(P<0.05).Conclusion Implementing SGB during laparoscopic radical resection of rectal cancer can effectively maintain hemodynamic stability,increase brain oxygen content,inhibit stress and inflammatory responses,and protect cognitive function in elderly patients.