超声引导SAPB与氟比洛芬酯麻醉对胸腔镜肺叶切除手术患者免疫应答与SP、NPY影响  

Influence of Ultrasound-guided SAPB and Flurbiprofen on the Immune Response and SP and NPY Levels in Patients Undergoing Thoracoscopic Lobectomy

作　　者：王启恒 高卫国 方亮[1] Wang Qiheng;Gao Weiguo;Fang Liang(Anesthesiology Department,The Second Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan,471000,China)

机构地区：[1]河南科技大学第二附属医院麻醉科,河南洛阳471000

出　　处：《黑龙江医学》2024年第17期2062-2065,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨超声引导下前锯肌平面阻滞(SAPB)复合氟比洛芬酯麻醉对胸腔镜肺叶切除手术患者免疫应答与P物质(SP)和神经肽Y(NPY)水平的影响。方法:选取2022年8月—2023年3月在河南科技大学第二附属医院接受胸腔镜肺叶切除手术的60例患者作为研究对象,随机分为两组,每组各30例。对照组(C组)给予常规麻醉,观察组(S组)在常规麻醉基础上行超声引导下SAPB复合氟比洛芬酯麻醉。比较两组患者的术后镇痛效果、术后24 h内舒芬太尼消耗量、术后恢复情况、术后1 h和24 h时血清IL-6、IL-10、TNF-α、SP和NPY水平。结果:S组患者的术后静息疼痛和活动疼痛的VAS评分均低于C组,差异有统计学意义(t=9.494、8.859、8.647、8.764;t=9.351、9.129、10.769、9.608,P<0.05);S组患者的术后恢复情况良好,与C组相比,术后恢复室(PACU)停留时间、拔管时间、住院时间均缩短,差异有统计学意义(t=7.843、6.234、4.562,P<0.05);S组患者的术后1 h和24 h时血清IL-6、TNF-α和SP水平低于C组,IL-10和NPY水平高于C组,差异有统计学意义(t=5.833、5.534;t=5.263、4.498;t=4.930、4.457;t=5.507、5.822;t=4.277、3.506,P<0.05)。结论:超声引导下SAPB复合氟比洛芬酯麻醉可以改善胸腔镜肺叶切除手术患者的术后镇痛效果,减少舒芬太尼消耗量,促进术后恢复,抑制炎症反应和应激反应,调节免疫应答及SP、NPY水平。Objective:To investigate the effects of ultrasound-guided SAPB combined with flurbiprofen axidate on immune response,SP and NPY levels in patients undergoing thoracoscopic lobectomy.Methods:A total of 60 patients who underwent thoracoscopic lobectomy in the hospital from August 2022 to March 2023 were randomly divided into two groups,with 30 cases in each group.The control group(group C)was given conventional anesthesia,and the observation group(group S)was given SAPB combined with flurbiprofen axidate under the guidance of ascending ultrasound on the basis of conventional anesthesia.The postoperative analgesia effect,morphine consumption within 24 h after surgery,postoperative recovery,serum levels of IL-6,IL-10,TNF-α,SP and NPY 1 h and 24 h after surgery were compared between the two groups.Results:VAS scores of postoperative resting pain and activity pain in group S were lower than those in group C,and the difference was statistically significant(t=9.494,8.859,8.647,8.764;t=9.351,9.129,10.769,9.608;P<0.05).The postoperative recovery of patients in group S was good,and compared with group C,the postoperative recovery room(PACU)residence time,extubation time and hospital stay were shortened,with statistically significant difference(t=7.843,6.234,4.562;P<0.05).The serum levels of IL-6,TNF-αand SP in group S were lower than those in group C 1 h and 24 h after surgery,and the levels of IL-10 and NPY were higher than those in group C,with statistically significant difference(t=5.833,5.534;t=5.263,4.498;t=4.93,4.457;t=5.507,5.822;t=4.277,3.506;P<0.05).Conclusion:Ultrasound-guided SAPB combined with flurbiprofen axidate can improve postoperative analgesia,reduce morphine consumption,promote postoperative recovery in patients undergoing thoracoscopic lobectomy,inhibit inflammatory response and stress response,and regulate immune response,SP and NPY levels.

关 键 词：超声引导下前锯肌平面阻滞 氟比洛芬酯 胸腔镜肺叶切除 免疫应答 P物质 神经肽Y 

分 类 号：R614[医药卫生—麻醉学]