双侧腹直肌鞘阻滞对老年胃癌根治术患者术后疼痛及T淋巴细胞亚群的影响研究

Effect of Bilateral Abdominalis Rectus Sheath Block on Postoperative Pain and T Lymphocyte Subsets in Elderly Patients undergoing Radical Gas⁃trectomy

目的探究双侧腹直肌鞘阻滞对老年胃癌根治术患者术后疼痛及T淋巴细胞亚群的影响。方法随机选取2022年6—12月福建省立医院收治的80例胃癌根治术老年患者为研究对象,通过随机数表法分为对照组和观察组,每组40例。常规组给予常规干预,对照组在常规干预的基础上进行双侧腹直肌鞘阻滞。比较两组患者手术前后的静息和运动视觉模拟量表评分、疼痛相关的炎症因子及T淋巴细胞亚群(CD3^(+)、CD4^(+)及CD8^(+))的变化。结果术后6、12、24、48 h观察组静息、运动视觉模拟量表评分低于对照组,差异有统计学意义(P<0.05)。术后24、48 h观察组血清疼痛相关炎症因子均低于对照组,差异有统计学意义(P<0.05)。术后24、48 h观察组CD8^(+)[(27.71±2.73)%、(28.51±2.79)%]低于对照组[(29.13±2.76)%、(30.71±3.01)%],差异有统计学意义(t=2.313、3.390,P<0.05)。术后48 h观察组CD3^(+)[(53.60±3.56)%]及CD4^(+)[(32.21±2.95)%]高于对照组,差异有统计学意义(t=3.059、2.661,P<0.05)。结论双侧腹直肌鞘阻滞减轻老年胃癌根治术患者术后早期疼痛,对T淋巴细胞亚群的不良影响小。

Objective To investigate the effects of bilateral abdominalis rectus sheath block on postoperative pain and T lymphocyte subsets in elderly patients undergoing radical gastrectomy.Methods Eighty cases of elderly patients ad⁃mitted to Fujian Provincial Hospital for radical gastric cancer surgery from June to December 2022 were randomly se⁃lected as the study objects,and were divided into the control group and the observation group by random number table method,with 40 cases in each group.The conventional group was given conventional intervention,and the control group was given bilateral rectus abdominis sheath block on the basis of conventional intervention.Resting and motor Visual Analog Scale scores,pain-related inflammatory factors and T-lymphocyte subpopulations(CD3^(+),CD4^(+)and CD8^(+))were compared between the two groups before and after surgery.Results The resting and motor Visual Analog Scale scores of the observation group were lower than those of the control group at 6 h,12 h,24 h and 48 h postopera⁃tively,and the differences were statistically significant(P<0.05).Serum pain-related inflammatory factors in the obser⁃vation group were lower than those in the control group at 24 h and 48 h postoperatively,and the difference was statis⁃tically significant(P<0.05).CD8^(+)[(27.71±2.73)%,(28.51±2.79)%]in the observation group was lower than that in the control group[(29.13±2.76)%,(30.71±3.01)%]in the observation group at 24 h and 48 h postoperatively,and the difference was statistically significant(t=2.313,3.390,P<0.05).CD3^(+)[(53.60±3.56)%]and CD4^(+)[(32.21±2.95)%]were higher in the observation group than those in the control group at 48 h postoperatively,and the difference was statisti⁃cally significant(t=3.059,2.661,P<0.05).Conclusion Bilateral abdominalis rectus sheath block alleviates early post⁃operative pain and has little adverse effect on T lymphocyte subsets in elderly patients undergoing radical gastrectomy.