超声引导下TAP联合双氯芬酸钠栓麻醉对腹腔镜下子宫切除患者认知水平、血浆IL-6、CRP、Cor浓度影响  

Influence of ultrasound-guided transversus abdominisplane combined with diclofenac sodium suppository for anesthesia during laparoscopic hysterectomy of the patients on their cognition level,and plasma interleukin-6,C-reactive protein,cortisol levels

作　　者：王丽娟[1] 庆晓峰 凌玲[1] 徐华 WANG Lijuan;QING Xiaofeng;LING Ling;XU Hua(Jiangning Hospital of Nanjing, Jiangsu Province, 21110)

机构地区：[1]南京市江宁医院,211100

出　　处：《中国计划生育学杂志》2021年第11期2332-2335,2340,共5页Chinese Journal of Family Planning

摘　　要：目的:探究超声引导下腹横肌平面(TAP)阻滞联合双氯芬酸钠栓对腹腔镜子宫切除术患者镇痛效果,并分析其对患者认知水平和血浆白细胞介素-6(IL-6)、C反应蛋白(CRP)、皮质醇(Cor)浓度的影响。方法:选取本院2018年10月-2020年10月行腹腔镜下子宫切除术患者100例,采用单双数标记法,单数为观察组、双数为对照组,两组各50例。对照组采用超声引导下腹横肌平面阻滞麻醉,观察组采用超声引导下腹横肌平面阻滞联合双氯芬酸钠栓。记录两组手术指标并分析术后疼痛、认知功能及血浆IL-6、CRP、Cor浓度差异。结果:观察组术后芬太尼用量、自主呼吸恢复时间、苏醒时间、下床时间均少于对照组(P<0.05)。术后48h,两组术后VAS评分均呈降低-升高-降低趋势,但观察组疼痛程度低于同期对照组(P<0.05)。与麻醉前相比,两组术后48h时Tau蛋白、Tau/Aβ-42值及IL-6、CRP、Cor浓度均升高,Aβ-42水平降低,但观察组Tau蛋白、Tau/Aβ-42值及IL-6、CRP、Cor浓度均低于对照组(P<0.05)。结论:超声引导下TAP阻滞联合双氯芬酸钠栓可提高术中术后麻醉效果,降低患者疼痛,同时减少麻醉对神经功能的负面影响,促进患者术后康复。Objective:To explore the clinical analgesic effect of ultrasound-guided transversus abdominisplane(TAP)block combined with diclofenac sodium suppository during laparoscopic hysterectomy,and to analyze its influence on cognitive level,and plasma interleukin-6(IL-6),C-reactive protein(CRP),cortisol(Cor)levels of patients.Methods:100 patients who had undergone laparoscopic hysterectomy were selected as the research objects from October 2018 to October 2020.These patients were divided in observation group and control group(50 cases in each group)by the odd and even number labeling method.The patients in the control group had received ultrasound-guided TAP block anesthesia,and the patients in the observation group had received ultrasound-guided TAP block combined with diclofenac sodium suppository.The surgical indicators of the patients in the two groups were recorded.The differences of postoperative pain,cognitive function,and plasma IL-6,CRP,and Cor levels of the patients in the two groups were analyzed.Results:The dosage of postoperative fentanyl used,the spontaneous breathing recovery time,the wake-up time,and the time to get out of bed of the patients in the observation group were significantly less than those of the patients in the control group(P<0.05).In 48 hours after operation,the VAS scores of the patients in the two groups all had showed a trend of decreasing-increasing-decreasing,but the pain degree of the patients in the observation group was significantly lower than that of the patients in the control group(P<0.05).Compared with those before anesthesia,the levels of Tau protein,Tau/Aβ-42 value,and the IL-6,CRP,Cor levels of the patients in the two groups at 48 hours after operation had increased significantly,but the Aβ-42 level of the patients in the two groups had decreased significantly.At 48h after operation,the Tau protein level,Tau/Aβ-42 value,and the levels of IL-6,CRP,and Cor of the patients in the observation group were significantly lower than those of the patients in the control group(P<0.

关 键 词：腹腔镜下子宫切除术 麻醉 镇痛 腹横肌平面阻滞 双氯芬酸钠栓 炎症指标 

分 类 号：R61[医药卫生—外科学]