胸椎旁阻滞联合全麻对老年肺癌根治术氧化应激反应和炎性反应的影响  

Effects of Thoracic Paravertebral Block Combined with General Anesthesia on Oxidative Stress and Inflammatory Response in Elderly Patients Undergoing Radical Resection of Lung Cancer

作　　者：洪甲庚[1] 陈曲敏[1] 林绍立[1] HONG Jiageng;CHEN Qumin;LIN Shaoli(The First Affiliated Hospital of Xiamen University,Xiamen 361003,China)

机构地区：[1]厦门大学附属第一医院,福建厦门361003

出　　处：《中外医学研究》2018年第30期6-8,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨老年肺癌根治术患者于超声引导下行胸椎旁神经阻滞联合全身麻醉对氧化应激反应和炎性反应的影响。方法:62例老年肺癌患者,抓阄法分GA组(31例,单纯全麻)、PG组(31例,超声引导下胸5椎旁神经阻滞联合全身麻醉)。观察麻醉前(T0)、诱导后15 min(T1)、切皮后10 min(T2)及拔管前(T3)平均动脉压(MAP)和心率(HR);并于术前(PT0)、术后2 h(PT1)、24 h(PT2)、48 h(PT3)抽血检测C-反应蛋白(CRP)、血清皮质醇(Cor)、IL-6和IL-10。结果:与T0时相比较,GA组T2、T3时点MAP和HR均明显升高(P<0.05);而PG组比较差异无统计学意义(P>0.05)。与GA组比较,PG组T2和T3时MAP和HR均比较低(P<0.05);PG组T0、T2、T3时MAP和HR未明显改变,差异无统计学意义(P>0.05)。与术前相比,两组不同时点炎性因子指标均升高(P<0.05);PT1、PT2、PT3时,PG组IL-6较比GA组更低;而IL-10除PT1时外,其余时点较GA组均更高,差异均有统计学意义(P<0.05)。与术前相比,两组不同时点CRP、Cor均升高,PG组在PT1、PT2、PT3时CRP、Cor水平低于同期GA组,差异均有统计学意义(P<0.05)。结论:老年肺癌手术者实施超声引导下胸椎旁神经阻滞复合全身麻醉,对术中循环平稳的维持以及炎性和应激反应的抑制,均可发挥显著价值。Objective：To investigate the effects of ultrasound-guided thoracic paravertebal blockade（TPVB）combined with general anesthesia on oxidative stress and inflammatory response in elderly patients undergoing radical lung cancer surgery.Method：A total of 62 elderly patients with lung cancer who underwent operation were divided into GA group （31,simple general anesthesia） and PG group （31,ultrasound guided thoracic 5 TPVB combined with general anesthesia）.The mean arterial pressure （MAP） and heart rate （HR） were measured before anesthesia （T0）,15 minutes after anesthesia induction （T1）, 10 minutes after skin incision （T2） and before extubation （T3）,and C-reactive protein （CRP）,serum cortisol （Cor）,IL-6 and IL-10 were detected at the time of preoperative （PT0）,postoperative 2 hours （PT1）,24 hours （PT2） and 48 hours （PT3）.Result： Compared with T0,MAP and HR in GA group were significantly higher than those at T2,T3 in GA group （P〈0.05）,but there was no significant difference in PG group （P〉0.05）.Compared with GA group,MAP and HR were lower at T2 and T3 in PG group （P〈0.05）.There was no significant difference in MAP and HR between PG group at T0,T2,T3（P〉0.05）.Compared with pre-operation,the inflammatory factors were increased at different time points in the two groups （P〈0.05）,the IL-6 of PG group was lower than that of GA group at PT1,PT2,PT3,and theIL-10 was higher than that of GA group except PT1 （P〈0.05）.Compared with pre-operation,the level of CRP,Cor in PG group was significantly higher than that in GA group at different time points （P〈0.05）,and the level of CRP,Cor in PG group was lower than that in GA group at different time points （P〈0.05）.

关 键 词：胸椎旁神经阻滞 老年肺癌根治术 全身麻醉 氧化应激反应 

分 类 号：R614[医药卫生—麻醉学]