B型超声引导下椎旁阻滞辅助全身麻醉对老年患者腔镜肺叶切除术后认知功能及早期恢复质量的影响  

Effect of B-ultrasound guided paravertebral block and general anesthesia on cognitive function and early recovery quality of elderly patients after thoracoscopic lobectomy

作　　者：穆彦 刘新燕[2] 齐胜娟 MU Yan;LIU Xin-yan;QI Sheng-juan(Department of Anesthesiology, the Second Central Hospital of Baoding, Hebei Province, Zhuozhou 072750, China;Department of Anesthesiology, Handan Central Hospital, Hebei Province, Handan 056001, China;Department of Anesthesiology, Zhuozhou City Hospital, Hebei Province, Zhuozhou 072750, China)

机构地区：[1]河北省保定市第二中心医院麻醉科,河北涿州072750 [2]河北省邯郸市中心医院麻醉科,河北邯郸056001 [3]河北省涿州市医院麻醉科,河北涿州072750

出　　处：《河北医科大学学报》2021年第3期324-329,共6页Journal of Hebei Medical University

基　　金：河北省科技计划项目(162777196)。

摘　　要：目的探讨B型超声引导下椎旁阻滞辅助全身麻醉对老年患者腔镜肺叶切除术后认知功能及早期恢复质量的影响。方法选取行腔镜肺叶切除术的老年患者100例,根据随机数字表法分为观察组和对照组各50例。对照组行全身麻醉,观察组行B型超声引导下椎旁阻滞辅助全身麻醉。比较2组简易精神状态检查表(mini-mental state examination,MMSE)评分、静息时与咳嗽时疼痛视觉模拟评分法(visual analogue scale,VAS)评分、手术相关指标、恢复质量及不良反应发生情况。结果麻醉后,2组MMSE评分均呈先降低后升高趋势,观察组变化幅度较小,组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.05)。观察组静息时、咳嗽时VAS评分呈先升高再降低趋势,对照组呈逐渐降低趋势,观察组静息时、咳嗽时VAS评分低于对照组,组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.05)。观察组苏醒室停留时间、拔管时间、进食时间、下床活动时间、住院时间均显著短于对照组,差异有统计学意义(P<0.05)。观察组疼痛、生理自理能力、心理、身体舒适度、情绪状态评分均显著高于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率显著低于对照组,差异有统计学意义(P<0.05)。结论B型超声引导下椎旁阻滞辅助全身麻醉能够有效改善腔镜肺叶切除术后老年患者的认知功能,提高其早期恢复质量。Objective To explore the effect of B-ultrasound-guided paravertebral block and general anesthesia on the cognitive function and early recovery quality of elderly patients after thoracoscopic lobectomy.Methods A total of 100 elderly patients undergoing thoracoscopic lobectomy were selected and divided into observation group(n=50)and control group(n=50)according to the random number table method.The control group underwent general anesthesia,and the observation group underwent B-ultrasound-guided paravertebral block and general anesthesia.The mini-mental state examination(MMSE)scores,visual analogue scale(VAS)scores for pain at rest and during cough,surgery-related indicators,recovery quality,and occurrence of adverse reactions were compared between two groups.Results After anesthesia,the MMSE scores of the two groups were decreased initially and then increased,and the change was slight in the observation group.The difference of interaction between groups,time points and time points between groups was statistically significant(P<0.05).The VAS scores of the observation group were increased initially and then decreased at rest and during cough.The control group showed a gradually decreasing trend.The VAS scores of the observation group at rest and during cough were lower than those of the control group.The difference of interaction between groups,time points and time points between groups was statistically significant(P<0.05).The length of ICU stay,extubation time,time to first oral food intake,off-bed time,and length of hospital stay in the observation group were significantly shorter than those in the control group,and the difference was statistically significant(P<0.05).The scores of pain,self-care ability,psychological and physical comfort,and emotional status of the observation group were significantly higher than those of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group,an

关 键 词：腔镜肺叶切除术 椎旁阻滞 全身麻醉 老年人 

分 类 号：R614.2[医药卫生—麻醉学]