全身麻醉复合硬膜外阻滞麻醉对肺癌根治术患者术后感染及疼痛评分的影响  

Effects of General Anesthesia Combined with Epidural Block Anesthesia on Postoperative Infection and Pain Score in Patients Undergoing Radical Resection of Lung Cancer

作　　者：杨卫[1] 刘钊 刘有才[1] YANG Wei;LIU Zhao;LIU Youcai(Zhengzhou Second People’s Hospital,Zhengzhou,450000)

机构地区：[1]郑州市第二人民医院,450000

出　　处：《实用癌症杂志》2020年第10期1646-1649,1683,共5页The Practical Journal of Cancer

摘　　要：目的探讨全身麻醉复合硬膜外阻滞麻醉对肺癌根治术患者术后感染及疼痛评分的影响。方法采用密封信封法,将112例肺癌根治术患者分为复合组(全身麻醉复合硬膜外阻滞麻醉,56例)和对照组(全身麻醉,56例),比较两组麻醉后恢复情况、术后感染发生率、视觉模拟评分(VAS)、术后认知功能障碍(POCD)发生率和麻醉前后免疫功能及血清白介素-2(IL-2)、S100β、胶质纤维酸性蛋白(GFAP)水平。结果复合组自主呼吸恢复时间、呼唤睁眼时间、拔管时间及术后感染发生率均低于对照组(P<0.05);两组术后2 h VAS评分比较,差异无统计学意义(P>0.05);复合组术后6、12、24 h VAS评分均明显低于对照组(P<0.05);复合组术后6、12、24 h POCD发生率均低于对照组(P<0.05),两组术后48、72 h POCD发生率无显著差异(P>0.05);两组麻醉前免疫功能和血清指标比较,差异无统计学意义(P>0.05);麻醉后24 h,复合组CD3^+、CD4^+、CD4^+/CD8^+水平均明显高于对照组(P<0.05),血清IL-2、S100β、GFAP水平均明显低于对照组(P<0.05)。结论全身麻醉复合硬膜外阻滞麻醉有助于缩短肺癌根治术患者术后苏醒时间,降低术后感染、POCD发生率,减轻术后疼痛和免疫功能抑制,值得临床推广。Objective To explore the effects of general anesthesia combined with epidural block anesthesia on postoperative infection and pain score in patients undergoing radical resection of lung cancer.Methods According to the sealed envelop methods,112 patients with radical resection of lung cancer were divided into combined group(general anesthesia combined with epidural block anesthesia,56 cases)and the control group(general anesthesia,56 cases).Recovery after anesthesia,incidence rate of postoperative infection,visual analogue scale(VAS),incidence rate of postoperative cognitive dysfunction(POCD),and immune function and levels of serum interleukin-2(IL-2),S100βand glial fibrillary acidic protein(GFAP)before and after anesthesia were compared between the 2 groups.Results The spontaneous breathing recovery time,blinking time,extubation time and incidence rate of postoperative infection in combined group were lower than those of the control group(P<0.05).There was no significant difference in the VAS score at 2h after operation between the 2 groups(P>0.05).The VAS score in combined group was significantly lower than that of the control group at 6,12 and 24 h after operation(P<0.05).The incidence rate of POCD in combined group was lower than that of the control group at 6,12 and 24 h after operation(P<0.05),and there was no significant difference in the incidence rate of POCD between the 2 groups at 48 and 72 h after operation(P>0.05).There were no significant differences in the immune function and serum indexes between the 2 groups before anesthesia(P>0.05).At 24 h after anesthesia,the levels of CD3^+,CD4^+and CD4^+/CD8^+in combined group were significantly higher than those of the control group(P<0.05),and the levels of serum IL-2,S100βand GFAP were significantly lower than those of the control group(P<0.05).Conclusion General anesthesia combined with epidural block anesthesia can shorten the postoperative recovery time,reduce the incidence rates of postoperative infection and POCD,and relieve the postoperative pain a

关 键 词：全身麻醉 硬膜外阻滞麻醉 肺癌根治术 术后感染 疼痛 

分 类 号：R734.2[医药卫生—肿瘤]