前锯肌平面阻滞对胸腔镜手术患者术后疼痛及机体免疫功能的影响  

Effect of serratus anterior plane block on postoperative pain and immune function in patients undergoing thoracoscopic surgery

作　　者：卢芳 尹琳 章绍金 袁海波 黄爱莲 李建华 LU Fang;YIN Lin;ZHANG Shaojin;YUAN Haibo;HUANG Ailian;LI Jianhua(Department of Anesthesiology,Yichun People′s Hospital,Jiangxi Province,Yichun336000,China)

机构地区：[1]江西省宜春市人民医院麻醉科,江西宜春336000

出　　处：《中国当代医药》2022年第4期120-123,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202120117)。

摘　　要：目的探讨前锯肌平面阻滞对胸腔镜手术患者术后疼痛及机体免疫功能的影响。方法选取2019年1月至2021年3月宜春市人民医院收治的70例胸腔镜相关手术患者作为研究对象,按照随机数字表法将其分为前锯肌平面阻滞(SAPB)组(35例)和胸椎旁神经阻滞(TPVB)组(35例)。SAPB组患者采用SAPB方法、TPVB组患者采用TPVB方法。比较两组患者的镇痛药品使用情况、疼痛评分、机体免疫功能。结果SAPB组丙泊酚、瑞芬太尼、舒芬太尼剂量少于TPVB组,差异有统计学意义(P<0.05)。SATB组静息、咳嗽状态疼痛评分低于TPVB组,差异有统计学意义(P<0.05)。两组患者术前机体免疫功能比较,差异无统计学意义(P>0.05)。SATB组术后1、2 d的C反应蛋白(CRP)、降钙素原(PCT)、CD^(3+)、CD^(4+)、CD^(4+)/CD^(8+)低于TPVB组,其CD^(8+)高于TPVB组,差异有统计学意义(P<0.05)。结论胸腔镜手术患者应用SAPB效果确切,不仅能减少阿片类药物使用量,减轻患者术后疼痛感,还能维持患者机体免疫功能正常,值得推荐。Objective To investigate the effect of serratus anterior plane block on postoperative pain and immune function in patients undergoing thoracoscopic surgery.Methods A total of 70 patients who underwent thoracoscopic related surgeries admitted to Yichun People′s Hospital from January 2019 to March 2021 were selected as the research subjects and were divided into serratus anterior plane block(SAPB)group(35 cases)and thoracic paravertebral block(TPVB)group(35 cases)by the random number table.The SAPB group were treated with SAPB,and the TPVB group were treated with TPVB.The use of analgesic drugs,pain scores and body immune function were compared between the two groups.Results The dose of propofol,remifentanil,and sufentanil in the SAPB group were lower than those in the TPVB group,and the differences were statistically significant(P<0.05).The pain score of the SATB group was lower than that of the TPVB group,and the difference was statistically significant(P<0.05).There was no significant difference in preoperative immune function between the two groups(P>0.05).The levels of C-reactive protein(CRP),procalcitonin(PCT),CD^(3+),CD^(4+)and CD^(4+)/CD^(8+)in the SATB group were lower than those in the TPVB group one day and two days after surgery,while CD^(8+)was higher than that in the TPVB group,and the differences were statistically significant(P<0.05).Conclusion In patients undergoing thoracoscopic surgery,SAPB has a definite effect,which can not only reduce the amount of opioids,alleviate postoperative pain,but also maintain the normal immune function of patients,which is worthy of recommendation.

关 键 词：胸腔镜手术 前锯肌平面阻滞 胸椎旁神经阻滞 术后疼痛 机体免疫功能 

分 类 号：R614[医药卫生—麻醉学]