连续前锯肌平面阻滞对胸腔镜下肺癌根治术患者氧合功能及多形核白细胞、脂联素、基质金属蛋白酶9水平的影响  

Effects of continuous anterior serratus plane block on oxygenation function and the levels of polymorphonuclear leukocytes,adiponectin,and matrix metalloproteinase-9 in patients undergoing thoracoscopic radical resection of lung cancer

作　　者：傅婕 李娜[1] 戚钰 梁婧 FU Jie;LI Na;QI Yu;LIANG Jing(Department of Anesthesiology,Xuzhou Central Hospital,Jiangsu Province,Xuzhou 221009,China)

机构地区：[1]江苏省徐州市中心医院麻醉科,江苏徐州221009

出　　处：《中国医药导报》2023年第34期129-133,共5页China Medical Herald

基　　金：江苏省社会发展(重点研发)项目(BE2019637)。

摘　　要：目的探讨连续前锯肌平面阻滞对胸腔镜下肺癌根治术患者氧合功能及多形核白细胞(PMN)、脂联素(ADP)、基质金属蛋白酶9(MMP-9)水平的影响。方法按照随机数字表法将2021年8月至2022年8月江苏省徐州市中心医院行单侧胸腔镜肺癌根治术的93例患者分为对照组和研究组;其中对照组46例,研究组47例。比较两组麻醉药物使用剂量;比较两组麻醉诱导前(T_(0))、术后即刻(T_(1))、拔管后2 h(T_(2))、拔管后6 h(T_(3))、拔管后24 h(T_(4))时的氧合指数(P/F);比较两组T_(2)~T_(4)时静息与活动状态视觉模拟评分法(VAS)评分;比较两组T_(0)、切皮后15 min(T_(5))、术后7 d(T_(6))PMN、ADP、MMP-9水平。结果两组舒芬太尼、瑞芬太尼、丙泊酚用量比较,差异无统计学意义(P>0.05)。整体分析发现:两组P/F组间、时间及交互作用比较,差异有统计学意义(P<0.05)。进一步两两比较,组内比较:对照组T_(0)~T_(4)时P/F两两比较,差异有统计学意义(P<0.05)。研究组T_(0)~T_(3)时P/F两两比较,差异有统计学意义(P<0.05);T_(4)时P/F高于T_(2)~T_(4)时,差异有统计学意义(P<0.05)。组间比较:两组T_(1)~T_(4)时P/F比较,差异有统计学意义(P<0.05)。整体分析发现:两组静息及活动状态VAS评分组间、时间及交互作用比较,差异有统计学意义(P<0.05)。进一步两两比较,组内比较:两组T_(2)~T_(4)时静息、活动状态VAS评分两两比较,差异有统计学意义(P<0.05);组间比较:研究组T_(2)~T_(4)时静息、活动状态VAS评分低于对照组,差异有统计学意义(P<0.05)。整体分析发现:两组PMN、ADP、MMP-9水平组间、时间点及交互作用比较,差异有统计学意义(P<0.05)。进一步两两比较,组内比较:对照组不同时间点PMN、ADP两两比较,差异有统计学意义(P<0.05);T_(5)~T_(6)时MMP-9水平高于T_(0)时,差异有统计学意义(P<0.05)。研究组不同时间点PMN、ADP、MMP-9水平两两比较,差异有统计学意义(P<0.05)。组间比Objective To investigate the effects of continuous anterior serratus plane block on oxygenation function and the levels of polymorphonuclear leukocytes(PMN),adiponectin(ADP),and matrix metalloproteinase-9(MMP-9)in patients undergoing thoracoscopic radical resection of lung cancer.Methods A total of 93 patients who underwent thoracoscopic radical resection of lung cancer in Xuzhou Central Hospital,Jiangsu Province from August 2021 to August 2022 were divided into control group and study group according to the random number table method;there were 46 cases in control group and 47 cases in study group.The dosage of narcotic drugs was compared between two groups;the oxygenation index(P/F)of two groups were compared before anesthesia induction(T_(0)),immediately after surgery(T_(1)),2 h after extubation(T_(2)),6 h after extubation(T_(3)),and 24 h after extubation(T_(4));visual analogue scale(VAS)scores were compared between two groups at T_(2)-T_(4);the levels of PMN,ADP,and MMP-9 were compared between two groups at T_(0),15 min after skin resection(T_(5)),and 7 d after surgery(T_(6)).Results There were no significant differences in dosage of Sufentanil,Remifentanil,and Propofol between two groups(P>0.05).The overall analysis showed that there were statistically significant differences between groups,time,and interaction of P/F between two groups(P<0.05).Further pairwise comparison and intra-group comparison:pairwise comparison of P/F between T_(0)-T_(4) in control group showed statistically significant difference(P<0.05).The pairwise comparison of P/F in T_(0)-T_(3) in study group were statistically significant(P<0.05);P/F at T_(4) was higher than that at T_(2)-T_(4),and the differences were statistically significant(P<0.05).Comparison between groups:there were statistical significance in P/F at T_(1)-T_(4) between two groups(P<0.05).The overall analysis showed that there were statistically significant differences between groups,time,and interaction of resting and active VAS between two groups(P<0.05).Further pairwis

关 键 词：连续前锯肌平面阻滞 胸腔镜 肺癌根治术 氧合功能 多形核白细胞 脂联素 

分 类 号：R734.2[医药卫生—肿瘤]