超声引导下腹横肌平面麻醉对无张力疝修补术患者血清Tau蛋白的影响

Effect of Ultrasound-guided Transversus Abdominis Plane Anesthesia on Serum Protein in Patients Undergoing Tension-free Hernia Repair

目的:探讨无张力疝修补术患者采用超声引导下腹横肌平面麻醉(TAPB)的临床效果及对血清蛋白的影响。方法:选取2018年2月-2019年2月于柳州市人民医院行无张力疝修补术的患者94例作为研究对象,采用随机数字表法分为对照组和观察组,各47例。对照组进行全身麻醉,观察组采用超声引导下TAPB,比较两组麻醉效果及对血清蛋白[β淀粉样蛋白(Aβ)-42、Tau]。结果:术后1、3 d,观察组简易精神状态检查量表评分高于对照组,差异有统计学意义(P<0.05)。观察组术后20 min、1 h、8 h及24 h的疼痛评分低于对照组,差异有统计学意义(P<0.05)。术后7 d,观察组Aβ-42水平高于对照组,Tau蛋白及Tau/Aβ-42水平低于对照组,差异有统计学意义(P<0.05)。结论:将超声引导下TAPB应用在无张力疝修补术患者中,可降低术后血清Tau蛋白水平,有助于预防认知功能障碍。

Objective:To explore the clinical effect of ultrasound-guided transversus abdominis plane anesthesia(TAPB)and its effect on serum protein in patients undergoing tension-free hernia repair.Methods:94 patients who underwent tension-free hernia repair at Liuzhou People's Hospital from February 2018 to February 2019 were selected as the research subjects and divided into a control group and an observation group using the random number table method,with 47 cases in each group.The control group received general anesthesia,and the observation group received ultrasound-guided transversus abdominis plane anesthesia.The anesthesia effects of the two groups were compared.Results:On days 1 and 3 after surgery,the Mini-Mental State Examination(MMSE)score of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05);the VAS scores of the observation group at 20 minutes,1 hour,8 hours and 24 hours after operation were lower than those of the control group,and the difference was statistically significant(P<0.05);on the 7th day after surgery,the Aβ-42 level in the observation group was higher than that in the control group,while the Tau protein and Tau/Aβ-42 levels were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:The application of ultrasound-guided TAPB in patients undergoing tension-free hernia repair can reduce postoperative serum Tau protein levels and help prevent cognitive dysfunction.