探究胸椎旁阻滞与硬膜外阻滞复合全身麻醉对开胸单肺通气手术麻醉及镇痛效果  

Explore the Anesthesia and Analgesic Effects of Combined Thoracic Paravertebral Block and Epidural Block Combined with General Anesthesia on Thoracotomy and Single Lung Ventilation

作　　者：李文波[1] LI Wen-bo(Department of Anesthesiology,Longnan Hospital of Daqing(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)麻醉科,黑龙江大庆163453

出　　处：《中外医疗》2020年第23期57-59,共3页China & Foreign Medical Treatment

摘　　要：目的探究胸椎旁阻滞与硬膜外阻滞复合全身麻醉对开胸单肺通气手术麻醉及镇痛效果。方法随机选取2017年3月-2019年8月该院收入的80例行开胸单肺通气手术的肺癌患者,将其按照数字随机表格的方法进行分组:研究组(n=40,胸椎旁阻滞复合全身麻醉)、比对组(n=40,硬膜外阻滞复合全身麻醉),对比两组行开胸单肺通气手术的肺癌患者的临床应用效果。结果比对组患者的麻醉起效时间为(49.78±9.29)s,平均麻醉阻滞节段数为(6.73±2.26),研究组患者的相关指标分别为(17.45±3.54)s、(5.31±1.15),差异有统计学意义(t=20.570,P=0.000;t=3.540,P=0.000);两组患者在术后6 h的VAS评分相比较差异无统计学意义(t=1.430,P=0.160);比对组患者在术后12 h、24 h、48 h的VAS评分与研究组患者相比,差异有统计学意义(t=12.360,P=0.000;t=9.140,P=0.000;t=4.500,P=0.000);与比对组患者相比,研究组患者在术后的不良反应发生率更低,差异有统计学意义(χ^2=6.486,P=0.011)。结论对于行开胸单肺通气手术的肺癌患者,可以采取胸椎旁阻滞复合全身麻醉的技术,其效果较为显著,值得推行。Objective To explore the anesthesia and analgesic effects of combined thoracic paravertebral block and epidural block combined with general anesthesia on thoracotomy and single lung ventilation surgery.Methods From rundom selection March 2017 to August 2019,80 patients with lung cancer who underwent open chest single lung ventilation surgery in the hospital were grouped according to the method of numerical random table:research group(n=40,parathoracic block combined with general anesthesia)and comparison group(n=40,combined with epidural block combined with general anesthesia)compared the clinical application of two groups of patients with lung cancer who underwent thoracotomy and single lung ventilation surgery.Results The onset time of anesthesia in the comparison group was(49.78±9.29)s,the average number of anesthesia block was(6.73±2.26),and the relevant indexes of the study group were(17.45±3.54)s and(5.31±1.15),by comparison,the difference was statistically significant(t=20.570,P=0.000;t=3.540,P=0.000);the VAS scores of the 2 groups of patients at 6 h postoperatively had no statistically significantly difference(t=1.430,P=0.16);the VAS scores of patients in the comparison group at 12 h,24 h,and 48 h after operation were statistically significantly difference from those in the study group(t=12.360,P=0.000;t=9.140,P=0.000;t=4.500,P=0.000);compared with patients in the control group,the incidence of postoperative adverse reactions in the study group was lower,the difference was statistically significant(χ^2=6.486,P=0.011).Conclusion For patients with lung cancer undergoing thoracotomy and single lung ventilation surgery,the technique of combined thoracic paravertebral block combined with general anesthesia can be used,and its effect is more significant and worth promoting.

关 键 词：开胸单肺通气手术 硬膜外阻滞 胸椎旁阻滞 全身麻醉 应用效果 

分 类 号：R5[医药卫生—内科学]