超声引导星状神经节阻滞对行结直肠癌手术治疗的衰弱老年患者心功能及胃肠功能影响  

Effects of ultrasound-guided stellate ganglion block(SGB)on cardiac function and gastrointestinal function in elderly patients undergoing colorectal cancer surgery

作　　者：徐宗雪 王亚芹 夏吉长 朱丽衡 高志杰 闫海珍 陆磊 XU Zongxue;WANG Yaqin;XIA Jichang;ZHU Liheng;GAO Zhijie;YAN Haizhen;LU Lei(Department of Anesthesiology,Huainan East Hospital Group General Hospital,Huainan Anhui 232000,China)

机构地区：[1]淮南市东方医院集团总医院麻醉科,安徽淮南232000

出　　处：《新疆医科大学学报》2024年第8期1140-1145,共6页Journal of Xinjiang Medical University

基　　金：安徽省自然科学基金项目(2108085M32)。

摘　　要：目的分析超声引导星状神经节阻滞(SGB)在行结直肠癌手术治疗的衰弱老年患者中的应用效果。方法回顾性分析2022年1月-2023年11月间本院收治的80例行结直肠癌手术治疗的衰弱老年患者临床资料,根据术中麻醉方法分成对照组(41例)和观察组(39例)。对照组予以全麻联合硬膜外麻醉,观察组在对照组基础上增加超声引导SGB。比较两组围术期相关指标、视觉模拟评分法(VAS)评分、应激指标、T_(0)(麻醉诱导前)、T_(1)(麻醉后5 min)、T_(2)(术毕)不同时刻的心功能、胃肠功能指标及不良反应。结果观察组舒芬太尼、丙泊酚用量、镇痛泵按压次数、补救镇痛率低于对照组(P<0.05)。术后2、12、24 h,两组VAS评分均逐渐下降,且观察组VAS评分均低于对照组(P<0.05)。术后,两组超氧化物歧化酶(SOD)、皮质醇(Cor)水平均高于术前,但观察组均低于对照组(P<0.05)。两组T_(1)、T_(2)时刻心率(HR)、心排血量(CO)、平均动脉压(MAP)水平均较T_(0)时刻升高,T_(2)时刻较T_(1)时刻下降,但观察组T_(1)、T_(2)时刻HR、CO、MAP水平低于对照组(P<0.05)。与对照组相比,观察组术后肠鸣音恢复、首次排气时间均缩短(P<0.05)。结论超声引导SGB用于老年衰弱结直肠癌患者,可减少术中麻醉药物用量,有效提升镇痛效果,减轻应激反应,对患者心功能及胃肠功能影响较小,且安全可靠。Objective:To analyze the effect of ultrasound-guided stellate ganglion block(SGB)in elderly patients undergoing surgical treatment for colorectal cancer.Methods:The clinical data of 80 elderly patients with frailty who underwent colorectal cancer surgery in the hospital from January 2022 to November 2023 were retrospectively analyzed.According to the intraoperative anesthesia method,thepatients were divided into a control group(41 cases)and an observation group(39 cases).The control group was given general anesthesia combined with epidural anesthesia,and the observation group was added ultrasound-guided SGB on the basis of the control group.The perioperative related indicators,visual analogue scale(VAS)score,stress index,cardiac function index level at different time points of T_(0)(before anesthesia induction),T_(1)(5 min after anesthesia),T_(2)(at the end of operation),gastrointestinal function and adverse reactions were compared between the 2 groups.Results:The consumption of sufentanil and propofol,pressing times of analgesic pump and rescue analgesia rate in the observation group were lower than those in the control group(P<0.05).At 2 h,12 h and 24 h after theoperation,the VAS scores of the 2 groups gradually weredecreased,and the VAS score of the observation group was lower than that of the control group(P<0.05).After the operation,the levels of superoxide dismutase(SOD)and cortisol(Cor)in the 2 groups were higher than those before theoperation,but those in the observation group were lower than those inthe control group(P<0.05).The levels of heart rate(HR),cardiac output(CO)and mean arterial pressure(MAP)at T_(1)and T_(2)in the 2 groups were higher than those at T_(0),and lower at T_(2)than those at T_(1),but the levels of HR,CO and MAP at T_(1)and T_(2)in the observation group were lower than those in the control group(P<0.05).Compared with the control group,the recovery time of bowel sounds and the first exhaust time were shortened in the observation group(P<0.05).Conclusion:Ultrasound-guided SGB for elde

关 键 词：结直肠癌 老年患者 超声引导星状神经节阻滞 心功能 胃肠功能 

分 类 号：R614.4[医药卫生—麻醉学] R735.3[医药卫生—外科学]