罗哌卡因联合帕瑞昔布钠前锯肌平面阻滞对胸腔镜下肺癌根治术患者术后免疫炎症反应和氧化应激的影响

Effects of Ropivacaine Combined with Parecoxib Sodium Serratus Anterior Plane Block on Postoperative Immune Inflammatory Response and Oxidative Stress in Patients Undergoing Thoracoscopic Radical Resection of Lung Cancer

目的:探讨罗哌卡因联合帕瑞昔布钠前锯肌平面阻滞(SAPB)对胸腔镜下肺癌根治术患者术后氧化应激、免疫炎症反应的影响。方法:按照随机数字表法将南通大学第六附属医院2021年1月~2023年4月期间110例择期进行胸腔镜下肺癌根治术的肺癌患者分为观察组(罗哌卡因联合帕瑞昔布钠SAPB,55例)、对照组(罗哌卡因SAPB,55例)。对比两组术后恢复情况、静息、咳嗽下的疼痛视觉模拟评分(VAS)、免疫功能、炎症反应和氧化应激变化情况,并观察两组治疗期间不良反应发生情况。结果:观察组的术后自主呼吸恢复时间、睁眼时间、拔管时间短于对照组(P<0.05)。观察组术后12 h(T2)~术后48 h(T4)静息VAS、咳嗽VAS低于对照组(P<0.05)。观察组T3时间点超氧化物歧化酶(SOD)、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组;丙二醛(MDA)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、CD8^(+)低于对照组(P<0.05)。对照组的不良反应为7.28%,观察组为10.92%,无统计学差异(P>0.05)。结论:罗哌卡因联合帕瑞昔布钠SAPB用于胸腔镜下肺癌根治术,可有效改善临床症状和免疫功能,减轻机体炎症和氧化应激。

Objective:To investigate the effects of ropivacaine combined with parecoxib sodium serratus plane block(SAPB)on postoperative oxidative stress and immune inflammatory response in patients undergoing thoracoscopic radical resection of lung cancer.Methods:According to the random number table method,110 patients with lung cancer who underwent thoracoscopic radical resection of lung cancer in The Sixth Affiliated Hospital of Nantong University from January 2021 to April 2023 were divided into observation group(ropivacaine combine with parecoxib sodium SAPB,55 cases)and control group(ropivacaine SAPB,55 cases).The postoperative recovery,visual analogue scale(VAS)of pain at rest and cough,immune function,inflammatory response and oxidative stress were compared between two groups,and the incidence of adverse reactions during treatment was observed.Results:The postoperative spontaneous breathing recovery time,eye opening time and extubation time in observation group were shorter than those in control group(P<0.05).The resting VAS and cough VAS in observation group were lower than those in control group 12 h(T2)~48 h(T4)after operation(P<0.05).The levels of superoxide dismutase(SOD),CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in observation group were higher than those in control group at T3 time point.Malondialdehyde(MDA),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and CD8^(+)were lower than those in control group(P<0.05).The adverse reactions in control group was 7.28%,and that in observation group was 10.92%,with no statistical difference(P>0.05).Conclusion:Ropivacaine combined with parecoxib sodium SAPB for thoracoscopic radical resection of lung cancer,which can effectively improve the clinical symptoms and immune function,reduce the body's inflammatory and oxidative stress.