腰方肌阻滞对腹腔镜结直肠癌根治术炎性反应及术后肠功能恢复的影响  

The effects of quadratus lumborum block on inflammatory response and postoperative intestinal function recovery in patients undergoing laparoscopic colorectal cancer surgery

作　　者：李宁康 马涛[1] 马旭[2] 周小红 杨丽峰[1] 张蕾 王云 LI Ningkang;MA Tao;MA Xu;ZHOU Xiaohong;YANG Lifeng;ZHANG Lei;WANG Yun(Department of Anesthesiology and Operation,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China;不详)

机构地区：[1]宁夏回族自治区人民医院麻醉手术部,银川750002 [2]宁夏医科大学第三临床医学院,银川750004

出　　处：《实用医学杂志》2023年第14期1769-1773,共5页The Journal of Practical Medicine

基　　金：宁夏回族自治区人民医院培育振兴科研项目资助(编号:202007)。

摘　　要：目的探讨腰方肌阻滞对腹腔镜结直肠癌根治术患者炎性反应及术后肠功能恢复的影响。方法将60例拟择期行腹腔镜结直肠癌根治术的患者随机分为腰方肌阻滞联合全麻组(观察组,n=30)和单纯全麻组(对照组,n=30)。观察组于全麻诱导前30 min行双侧腰方肌阻滞,对照组行单纯全麻。检测麻醉诱导前5 min(T_(0))、气腹完成时(T_(1))、术后6 h(T_(2))及术后24 h(T_(3))血清TNF-α、IL-6和IL-10浓度,记录术后首次排气时间、术后首次下床行走时间以及腹胀的发生率和程度。结果与对照组相比,观察组各时间点炎性因子的水平均明显降低(P<0.05);观察组术后首次排气时间明显短于对照组(P<0.05),且术后首次下床行走时间明显长于对照组(P<0.05);观察组术后腹胀的发生率明显低于对照组(P<0.05)。结论术前行腰方肌阻滞可明显减轻腹腔镜结直肠癌根治术患者的炎性反应并促进患者术后肠功能的快速恢复。Objective To investigate the effects of quadratus lumborum block on inflammatory response and postoperative intestinal function recovery in patients undergoing laparoscopic colorectal cancer surgery.Methods A total of 60 patients scheduled for laparoscopic colorectal cancer surgery were randomly divided into two groups:quadratus lumborum block combined with general anesthesia group(group QA,n=30)and sole general anesthesia group(group GA,n=30).The patients in group QA received bilateral quadratus lumborum block 30 minutes before induction of general anesthesia,and in group GA received simple general anesthesia,respectively.The concentration of serum TNF-α,IL-6 and IL-10 was measured at the following time points:5 minutes before anesthesia induction(T_(0)),at the completion of pneumoperitoneum establishment(T_(1)),6 h(T_(2))and 24 h(T_(3))after operation.The time of first exhaust and first walking time after operation,the incidence and degree of abdominal distension were recorded.Results Compared with the group GA,the levels of inflammatory factors at all time points in the group QA were significantly lower(P<0.05).The time of first exhaust in the group QA was significantly shorter than that in the group GA(P<0.05),and the first walking time after operation in the group QA was significantly longer than that in the group GA(P<0.05).The incidence of postoperative abdominal distension in the group QA was significantly lower than that in the group GA(P<0.05).Conclusions Quadratus lumborum block before operation can significantly reduce the inflammatory response and promote the rapid recovery of intestinal function in patients undergoing laparoscopic colorectal cancer surgery.

关 键 词：腰方肌阻滞 结直肠癌 炎性反应 肠功能 

分 类 号：R614[医药卫生—麻醉学]