超声引导连续胸椎旁神经阻滞复合右美托咪定麻醉对食管癌手术患者围术期应激反应的影响  

Effects of Ultrasound-guided Continuous Thoracic Paravertebral Nerve Block Combined with DexmedetomidineAnesthesia on Perioperative Stress Response in Patients Undergoing Esophageal Cancer Surgery

作　　者：田春梅[1] 李文波[1] 刘伟[1] 华庆丽 李阳[1] 苑妍新[1] TIAN Chun-mei;LI Wen-bo;LIU Wei;HUA Qing-li;LI Yang;YUAN Yan-xin(Daqing Longnan Hospital(The Fifth Affiliated Hospital of Qiqihar Medical College),Daqing,Heilongjiang Province,163453,China)

机构地区：[1]大庆龙南医院(齐齐哈尔医学院第五附属医院),黑龙江大庆163453

出　　处：《中外医疗》2020年第22期119-121,共3页China & Foreign Medical Treatment

摘　　要：目的超声引导连续胸椎旁神经阻滞复合右美托咪定麻醉对食管癌手术患者围术期应激反应的影响。方法方便选取2018年11月-2019年11月来该院的78例食管癌手术患者作为研究对象,按照入院顺序将其分为研究组(n=39例)与对照组(n=39例),给予研究组患者超声引导连续胸椎旁神经阻滞复合右美托咪定麻醉,给予对照组患者常规全身麻醉,随后评价麻醉效果、血流动力学指标、收缩压及舒张压。结果研究组麻醉效果94.87%相较对照组71.79%明显偏高,差异有统计学意义(χ^2=7.47,P=0.00)。研究组血流动力学指标(109.5±14.2)mmHg、(87.3±15.4)次/min明显优于对照组(96.5±14.7)mmHg、(79.7±14.3)次/min,差异有统计学意义(t=3.97,P=0.00;t=2.25,P=0.02)。研究组收缩压(134.36±12.24)mmHg及舒张压(89.23±6.78)mmHg显著优于对照组(123.37±10.65)mmHg、(81.24±7.23)mmHg,差异有统计学意义(t=4.23,P=0.000;t=5.03,P=0.00)。结论超声引导连续胸椎旁神经阻滞复合右美托咪定麻醉对食管癌手术患者具有显著的麻醉效果,既能确保麻醉安全性,又能减少患者围术期应激反应。Objective To investigate the effect of continuous thoracic paravertebral nerve block combined with dexmedetomidine anesthesia on perioperative stress response in patients undergoing esophageal cancer surgery.Methods 78 cases of esophageal cancer surgery patients in the hospital from November 2018 to November 2019 were convenient selected and divided into study group(n=39 cases)and control group(n=39 cases)according to the order of admission.Patients in the study group were given ultrasound-guided continuous thoracic paravertebral nerve block combined with right metomidine anesthesia,and patients in the control group were given general anesthesia,and then the anesthesia effect and hemodynamics were evaluated Index,systolic and diastolic blood pressure.Results 94.87%of the anesthesia effect in the study group was significantly higher than 71.79%in the control group(χ^2=7.47,P=0.00).The hemodynamic indexes of the study group(109.5±14.2)mmHg,(87.3±15.4)times/min were significantly better than those of the control group(96.5±14.7)mm Hg,(79.7±14.3)times/min,the difference was statistically significant(t=3.97,P=0.00;t=2.25,P=0.02).The systolic blood pressure(134.36±12.24)mmHg and diastolic blood pressure(89.23±6.78)mmHg in the study group were significantly higher than those in the group(123.37±10.65)mmHg,(81.24±7.23)mmHg,with significant difference(t=4.23,P=0.000;t=5.03,P=0.00).Conclusion Continuous thoracic paravertebral nerve block combined with dexmedetomidine anesthesia under ultrasound guidance has a significant anesthetic effect on patients undergoing esophageal cancer surgery.It can not only ensure the safety of anesthesia,but also reduce perioperative stress response of patients.It should be widely used in clinical practice.

关 键 词：超声引导 胸椎旁 神经阻滞 右美托咪定 食管癌 

分 类 号：R5[医药卫生—内科学]