腹横肌平面阻滞对腹腔镜胆囊切除术患者血清S-100β、NSE及氧化应激水平的影响

Influence of transversus abdominis plane block on serum S⁃100β,NSE and oxidative stress in patients with laparoscopic cholecystectomy

目的 探究腹横肌平面阻滞对腹腔镜胆囊切除术患者血清中枢神经特异性蛋白(S-100β)、神经元特异性烯醇化酶(NSE)及氧化应激水平的影响。方法 选取2020年6月至2023年1月于无为市人民医院就诊的130例行腹腔镜胆囊切除术患者作为研究对象,据简单随机化法分为观察组和对照组,每组各65例。对照组术前采用常规插管麻醉,观察组术前在对照组基础上联合腹横肌平面阻滞进行麻醉。对比两组手术前、后血清S-100β、NSE以氧化应激指标[皮质醇(Cor)、肾上腺素]、炎性介质[血清C反应蛋白(CRP)、白介素-6(IL-6)、白介素-2 (IL-2)]的变化,记录苏醒时间、术后疼痛情况以及不良症状发生率。结果 观察组术后血清S-100β、NSE、Cor、肾上腺素水平低于对照组,差异有统计学意义(P<0.05)。观察组炎性因子CRP、IL-6、IL-2水平显著低于对照组,差异有统计学意义(P<0.05)。术后观察组VAS评分及不良症状发生率均显著低于对照组,苏醒时间显著短于对照组,差异有统计学意义(P<0.05)。结论 腹横肌平面阻滞应用于行腹腔镜胆囊切除术患者效果显著,可有效减少炎性损伤和应激反应,适合临床推广应用。

Objective To explore the influence of transversus abdominis plane block on serum cen-tral nervous specific protein(S-100β),neuron specific enolase(NSE)and oxidative stress in patients undergo-ing laparoscopic cholecystectomy.Methods 130 patients undergoing laparoscopic cholecystectomy at Wuwei City Peoples Hospital were enrolled as the research subjects from June 2020 to January 2023.Using a simple randomization method,they were divided into an observation group and a control group with 65 cases in each group.The control group received conventional intubation anesthesia before surgery,while the observation group received transversus abdominis plane block anesthesia based on the control group.Changes in serum S-100β,NSE,oxidative stress indicators[cortisol(Cor),epinephrine]and inflammatory mediators[serum C-re-active protein(CRP),interleukin-6(IL-6),interleukin-2(IL-2)]were compared before and after surgery.Re-covery time,postoperative pain levels and incidence rates of adverse symptoms were recorded.Results The levels of serum S-100β,NSE,Cor and epinephrine in the observation group after surgery were lower than those in the control group(P<0.05).The levels of inflammatory factors of CRP,IL-6,and IL-2 were significantly lower in the observation group(P<0.05).The VAS score and incidence rates of adverse symptoms in the obser-vation group after surgery were significantly lower compared to the control group,and the recovery time was significantly shorter than that in the control group(P<0.05).Conclusion The transversus abdominis plane block has a significant effect on patients undergoing laparoscopic cholecystectomy,and it can effectively allevi-ate inflammatory injury and stress response.