腹横肌平面阻滞和局部浸润麻醉对腹腔镜下结肠癌根治术患者中性粒细胞凋亡指数的影响对比  

Comparison of the Effects of Transversus Abdominis Plane Block and Local Infiltration Anesthesia on Neutrophil Apoptotic Index in Patients Undergoing Laparoscopic Radical Colon Cancer Surgery

作　　者：陆克功 王宏 韩红 LU Kegong;WANG Hong;HAN Hong(Zhangye People's Hospital Affiliated to Hexi University,Zhangye 734000,China;不详)

机构地区：[1]河西学院附属张掖人民医院,甘肃张掖734000 [2]甘肃省张掖市第二人民医院

出　　处：《中国医学创新》2023年第29期1-5,共5页Medical Innovation of China

基　　金：2022年度张掖市市级科技计划——B类计划(自筹资金)项目(ZY2022BJ18,ZY2022BJ19)。

摘　　要：目的:探讨与比较腹横肌平面阻滞和局部浸润麻醉对腹腔镜下结肠癌根治术患者中性粒细胞凋亡指数的影响。方法:选择2019年6月—2022年3月河西学院附属张掖人民医院接受腹腔镜下结肠癌根治术治疗的结肠癌患者100例作为研究对象,根据随机数字表法把100例患者分为研究组、对照组各50例,对照组给予局部浸润麻醉,研究组给予腹横肌平面阻滞,比较患者术后恢复情况、术后不同时间的疼痛视觉模拟评分法(VAS)评分、中性粒细胞凋亡指数。结果:研究组术后住院时间短于对照组,研究组术后首次下床时间、术后首次排气时间、术后流质饮食时间均明显早于对照组(P<0.05)。研究组术后7 d的低血压、心动过缓、恶心呕吐、偏头痛等不良反应发生率为4.0%,显著低于对照组的30.0%(P<0.05)。研究组术后6、12、24、48 h疼痛VAS评分均显著低于对照组(P<0.05)。研究组术后1、2、3 d的中性粒细胞凋亡指数均显著高于对照组(P<0.05)。结论:相对于局部浸润麻醉,腹横肌平面阻滞在腹腔镜下结肠癌根治术患者中应用能促进中性粒细胞凋亡,具有更好的镇痛效果,还能促进患者康复,减少不良反应的发生。Objective:To investigate and compare the effects of transverse abdominal plane block and local infiltration anesthesia on the neutrophil apoptotic index of the patients with laparoscopic radical surgery of colon cancer.Method:One hundred colon cancer patients who underwent laparoscopic radical surgery of colon cancer at Zhangye People's Hospital Affiliated to Hexi University from June 2019 to March 2022 were selected as the experimental subjects.The patients were divided into the experimental group and the control group according to the random number table method,50 cases in each group,and the control group was given local infiltration anesthesia while the experimental group was given transversus abdominis plane block.The patients'postoperative recovery,visual analogue scale(VAS)score of pain at different postoperative time points,and neutrophils apoptosis index in the patients were compared.Result:The postoperative hospital stay in the experimental group was shorter than that in the control group,the first postoperative time to get out of bed,first postoperative ventilation time,and postoperative fluid diet time in the experimental group were significantly earlier than those in the control group(P<0.05).The incidence of adverse reactions such as hypotension,bradycardia,nausea and vomiting,and migraine at 7 days postoperatively in the experimental group was 4.0%,which was significantly lower than 30.0% in the control group(P<0.05).The pain VAS scores in the experimental group were significantly lower than those in the control group at 6,12,24 and 48 hours postoperatively(P<0.05).The neutrophils apoptosis indexs in the experimental group were significantly higher than those in the control group at 1,2,3 d after surgery(P<0.05).Conclusion:Compared with local infiltration anesthesia,transversus abdominis plane block in patients undergoing laparoscopic radical colon cancer promotes neutrophil apoptosis and has a better analgesic effect,as well as promotes patient recovery and reduces the incidence of adverse reaction

关 键 词：局部浸润麻醉 腹横肌平面阻滞 腹腔镜下结肠癌根治术 中性粒细胞 疼痛 不良反应 

分 类 号：R735.35[医药卫生—肿瘤] R614[医药卫生—临床医学]