全身麻醉联合颈丛神经阻滞对老年甲状腺癌手术患者血糖和激素水平及炎症因子的影响研究  

Study on the effects of general anesthesia combined with cervical plexus block on blood glucose and hormone levels and inflammatory factors in elderly patients undergoing thyroid cancer surgery

作　　者：张清 王兰 黎丽娟 ZHANG Qing;WANG Lan;LI Lijuan(Department of Anesthesiology,the Third People's Hospital of Jingzhou,Jingzhou,Hubei,434000,China)

机构地区：[1]荆州市第三人民医院麻醉科,湖北荆州434000

出　　处：《当代医学》2024年第12期90-94,共5页Contemporary Medicine

摘　　要：目的探讨全身麻醉联合颈丛神经阻滞对老年甲状腺癌手术中患者血糖、激素水平及炎症因子的影响。方法回顾性分析2018年2月至2021年2月于荆州市第三人民医院行甲状腺癌切除术的89例老年患者的临床资料,根据手术麻醉方式的不同分为对照组(n=45)与研究组(n=44)。对照组采用全身麻醉,研究组采用全身麻醉联合颈丛神经阻滞。比较两组不同时间[麻醉前5 min(T_(1))、手术开始后10 min(T_(2))、肿瘤切除时(T_(3))、术毕(T_(4))、术后12 h(T5)]血糖及激素[皮质醇(Cr)、肾上腺素(E)、去甲肾上腺素(NE)]水平、手术前后炎症因子[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]水平及术后不良反应发生情况。结果T_(1)、T_(2)、T5时,两组血糖、Cr、E、NE水平比较,差异无统计学意义;T_(3)、T_(4)时,研究组血糖、Cr、E、NE水平均低于对照组,差异有统计学意义(P<0.05)。术后24 h,研究组hs-CRP、IL-6水平均低于对照组,差异有统计学意义(P<0.05)。两组术后不良反应发生率比较差异无统计学意义。结论全身麻醉联合颈丛神经阻滞应用于老年甲状腺癌手术患者中,能有效抑制术中应激反应,减轻术后炎症反应,促进患者术后恢复,且具有较高的安全性。Objective To investigate the effects of general anesthesia combined with cervical plexus block on blood glucose,hormone levels and inflammatory factors in elderly patients undergoing thyroid cancer surgery.Methods The clinical data of 89 elderly patients who undergoing thyroid cancer surgery in Third People's Hospital of Jingzhou from February 2018 to February 2021 were retrospective analyzed,they were divided into the control group(n=45)and the study group(n=44)according to the different anesthesia methods.The control group was given general anesthesia,while the study group was given general anesthesia combined with cervical plexus block.The blood glucose and hormone(cortisol[Cr],adrenaline[E],norepinephrine[NE])levels at different times(5 min before anesthesia[T_(1)],10 min after surgery[T_(2)],at tumor resection[T_(3)],after surgery[T_(4)],12 h after surgery[T5]),the levels of inflammatory factors(hypersensitive C-reactive protein[hs-CRP],interleukin-6[IL-6])before and after surgery and the occurrence of postoperative adverse reactions were compared between the two groups.Results At T_(1),T_(2),and T5,there were no statistically significant difference in blood glucose,Cr,E,and NE levels;at T_(3) and T_(4),blood glucose,Cr,E,and NE levels in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).24 h after surgery,the levels of hs-CRP and IL-6 in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant differ-ence in the incidence of postoperative adverse reactions between the two groups.Conclusion The application of general anesthesia combined with cervical plexus block in elderly patients undergoing thyroid cancer surgery can effectively inhibit intraoperative stress response,reduce postoperative inflammatory response,can promote postoperative recovery of patients,and has high safety.

关 键 词：甲状腺癌 全身麻醉 颈丛神经阻滞 血糖 激素 炎症因子 

分 类 号：R614[医药卫生—麻醉学]