不同神经阻滞麻醉方案对胃癌根治患者术后疼痛、认知功能及血清Aβ-42、IL-6、tau-181蛋白影响  

Effects of different nerve block anesthesia protocols on postoperative pain,cognitive function and serum Aβ⁃42,IL⁃6 and tau⁃181 protein in patients with radical gastrectomy for gastric cancer

作　　者：王佳奕 冯腾尘 汪业铭[1] 樊娟[1] 孙晓佳 赵继波[1] WANG Jiayi;FENG Tengchen;WANG Yeming;FAN Juan;SUN Xiaojia;ZHAO Jibo(Department of Anesthesiology,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Shijia-zhuang,China,075000)

机构地区：[1]河北北方学院附属第一医院麻醉科,河北张家口075000

出　　处：《分子诊断与治疗杂志》2024年第3期421-424,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河北省医学科学研究课题计划项目(20220620);张家口市科技计划自筹经费项目(2121134D)。

摘　　要：目的 探讨不同神经阻滞麻醉方案[椎旁神经阻滞术(TPVB)和星状神经节阻滞术(SGB)]对胃癌根治患者术后疼痛、认知功能及血清β淀粉样蛋白-42(Aβ-42)、白细胞介素-6(IL-6)、tau-181蛋白影响。方法 选取河北北方学院附属第一医院2020年1月至2023年1月收治的择期行腹腔镜胃癌根治术的患者120例为研究对象,按照随机数字表法分为TPVB组和SGB组,各60例。两组术中全麻方式相同,TPVB组在麻醉诱导前进行椎旁神经阻滞术,SGB组在麻醉诱导前进行星状神经节阻滞术。分别采用视觉模拟评分法(VAS)及蒙特利尔认知评估量表(MoCA)评估患者疼痛情况及认知功能;监测两组术后不同时间点疼痛变化情况,比较两组术前、术后1、3 d的认知功能及血清Aβ-42、IL-6、tau-181蛋白水平变化。结果 两组术后1、6、12、24 h的VAS评分差异均无统计学意义(t=1.183、1.325、0.397、0.611,P>0.05);术后1、3 d两组MoCA量表评分比较为TPVB组评分低于SGB组,差异均有统计学意义(t=2.281、3.218,P<0.05);术后1、3 d两组血清指标比较均为TPVB组Aβ-42、IL-6及tau-181蛋白水平高于SGB组,差异均有统计学意义(t=2.065、2.122、2.558、2.167、2.515、2.596,P<0.05)。结论 TPVB及SGB两种神经阻滞麻醉方案对胃癌根治患者术后镇痛均有良好的效果,但SGB比TPVB在减轻患者炎症反应及认知功能的改善方面更具优势。Objective To investigate the effects of different nerve block anesthesia schemes[para-vertebral nerve block(TPVB)and stellate ganglion block(SGB)]on postoperative pain,cognitive function,and serumβ-amyloid protein-42(Aβ-42),interleukin-6(IL-6)and tau-181 protein in patients undergoing rad-ical gastrectomy.Methods A total of 120 patients undergoing elective laparoscopic radical gastrectomy for gastric cancer at the First Affiliated Hospital of Hebei North University from January 2020 to January 2023 were selected as the research subjects.Using the random number table method,they were divided into two groups:the TPVB group and the SGB group,with 60 cases in each group.Both groups received the same gen-eral anesthesia method.The TPVB group received a paravertebral nerve block before anesthesia induction,while the SGB group received a progressive stellate ganglion block before anesthesia induction.Pain and cogni-tive function were assessed using the Visual Analogue Scale(VAS)and the Montreal Cognitive Assessment Scale(MoCA).The changes in pain at different time points after the operation were monitored in both groups.The changes in cognitive function and levels of serum Aβ-42,IL-6 and tau-181 protein before the operation,1 day and 3 days after the operation were compared between the two groups.Results There was no significant difference in VAS scores between the two groups at 1,6,12,and 24 hours after the operation(t=1.183,1.325,0.397,0.611,P>0.05).The scores of the MoCA scale in the TPVB group were lower than those in the SGB group at 1 and 3 days after the operation,and the differences were statistically significant(t=2.281,3.218,P<0.05).The levels of Aβ-42,IL-6 and tau-181 protein in the TPVB group were higher than those in the SGB group at 1 and 3 days after the operation,and the differences were statistically significant(t=2.065,2.122,2.558,2.167,2.515,2.596,P<0.05).Conclusion Both TPVB and SGB nerve block anesthesia tech-niques have positive effects on postoperative analgesia in patients undergoing radical

关 键 词：神经阻滞麻醉方案 腹腔镜胃癌根治术 认知功能 β淀粉样蛋白-42 白细胞介素-6 tau-181蛋白 

分 类 号：R614[医药卫生—麻醉学] R735.2[医药卫生—外科学]