超声引导椎旁神经阻滞联合心理指导胸腔镜肺癌根治术老年患者认知功能的影响研究  

Effect of Ultrasound Guided Paravertebral Nerve Block Combined with PsychologicalGuidance on Cognitive Function of Elderly Patients with Lung Cancer UndergoingThoracoscopic Radical Resection

作　　者：盛思玉 蒋玲[1] 李雪 徐松艳 陈莎莎 SHENG Siyu;JIANG Ling;LI Xue;XU Songyan;CHEN Shasha(Huaiyin Hospital of Huai'an City,Huai'an,Jiangsu 223300,China)

机构地区：[1]淮安市淮阴医院,江苏淮安223300

出　　处：《大医生》2021年第2期13-15,共3页Doctor

摘　　要：目的探讨超声引导椎旁神经阻滞联合心理指导在老年胸腔镜肺癌根治术患者中的应用效果及对患者认知功能的影响。方法选取淮安市淮阴医院2018年1月至2020年5月收治的68例老年胸腔镜肺癌根治术患者为研究对象,采用随机数字表法分为对照组和观察组,各34例。对照组采用超声引导椎旁神经阻滞,观察组在对照组基础上联合心理指导,治疗7 d后对患者治疗效果进行评估,比较两组视觉模拟疼痛(VAS)评分、简易精神状态量表(MMSE)评分、苏醒时间、并发症发生率。结果观察组术后7 d的VAS、MMSE评分及自主呼吸恢复、呼之睁眼反应时间低(短)于对照组(P<0.05);两组围术期恶心呕吐、呼吸抑制、血压波动、吞咽障碍、头晕嗜睡发生率比较差异无统计意义(P>0.05)。结论超声引导椎旁神经阻滞联合心理指导用于老年胸腔镜肺癌根治术患者中能减轻患者疼痛,改善患者认知功能,有助于缩短患者苏醒时间,未增加并发症发生率,值得推广应用。Objective To investigate the application effect of ultrasound guided paravertebral nerve block combined with psychological guidance in elderly patients with thoracoscopic lung cancer radical surgery and its influence on cognitive function.Methods A total of 68 elderly patients with thoracoscopic radical resection of lung cancer admitted to Huaiyin Hospital of Huai'an City from January 2018 to May 2020 were selected as the research subjects,and were divided into control group and observation group by random number table method,with 34 cases in each group.The control group was treated with ultrasonic-guided paravertinal nerve block,and the observation group was combined with psychological guidance on the basis of the control group.After 7 days of nursing,the effect of patients was evaluated.The visual analog pain(VAS)score,simple mental state scale(MMSE)score,awakening time and complication rate were compared between the two groups.Results The VAS,MMSE scores,spontaneous breathing recovery and eye opening time of the observation group were lower(shorter)than those of the control group(P<0.05);the incidence of nausea and vomiting,respiratory depression,blood pressure fluctuation,dysphagia,dizziness and drowsiness in the two groups were not statistically significant(P>0.05).Conclusion Ultrasound guided paravertebral nerve block combined with psychological guidance in elderly patients with thoracoscopic lung cancer radical surgery can reduce the pain of patients,improve the cognitive function of patients,help to shorten the recovery time of patients,without increasing the incidence of complications,which is worthy of promotion and application.

关 键 词：超声引导椎旁神经阻滞 心理指导 胸腔镜肺癌根治术 认知功能 

分 类 号：R614.4[医药卫生—麻醉学]