超声引导下星状神经节阻滞联合静吸复合麻醉在肺癌根治术中的应用效果  

The Effect of Ultrasound-guided Stellate Ganglion Block Combined with Intravenous and Inhalation Anesthesia on Hemodynamics in Patients Underwent Radical Lung Cancer Surgery

作　　者：葛军甫 韩学昌[1] 马孝武[1] 张亚杰 GE Junfu;HAN Xuechang;MA Xiaowu(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,471003)

机构地区：[1]河南科技大学第一附属医院,471003

出　　处：《实用癌症杂志》2025年第2期238-242,共5页The Practical Journal of Cancer

摘　　要：目的探讨超声引导下星状神经节阻滞(SGB)联合静吸复合麻醉在肺癌根治术中的应用效果。方法回顾性分析86例肺癌根治术患者,根据术中麻醉方式分为对照组(静吸复合麻醉,n=45)和观察组(超声引导下SGB联合静吸复合麻醉,n=41)。比较2组入室时、麻醉诱导即刻、手术30 min、术毕时血流动力学[心率(HR)和平均动脉压(MAP)],2组术后指标,2组术后6 h、12 h、24 h、48 h的镇痛效果[数字等级评分法(NRS)],2组术前1 d、术后d1、术后d3、术后d5的认知功能[简易智能检查量表(MMSE)和蒙特利尔认知量表(MoCA)],统计2组不良反应。结果2组入室时至术毕时HR、MAP先降低后升高,但观察组波动幅度更小,组间、时点、组间·时点比较,差异有统计学意义(P<0.05)。观察组自控镇痛泵(PCA)舒芬太尼用量、PCA按压次数少于对照组(P<0.05)。2组术后6 h至术后48 h时NRS评分先升高后降低,组间、时点、组间·时点比较,差异有统计学意义(P<0.05)。2组术后d1至术后d5时MMSE评分、MoCA评分先降低后升高,组间、时点、组间·时点比较,差异有统计学意义(P<0.05)。观察组恶心呕吐发生率低于对照组(P<0.05)。结论超声引导下SGB联合静吸复合麻醉可稳定肺癌根治术患者血流动力学,减轻其术后疼痛,加快认知功能恢复,降低恶心呕吐发生率。Objective To explore the effect of ultrasound-guided stellate ganglion block(SGB)combined with intravenous and inhalation anesthesia on hemodynamics in patients underwent radical lung cancer surgery.Methods A retrospective analysis was conducted on 86 patients who underwent radical lung cancer surgery.They were divided into the control group(combined intravenous and inhalation anesthesia,n=45)and the observation group(ultrasound-guided SGB combined with combined intravenous and inhalation anesthesia,n=41)based on different intraoperative anesthesia methods.The hemodynamics[heart rate(HR)and mean arterial pressure(MAP)]were compared between the 2 groups at the time of entering the room,immediately after anesthesia induction,30 min after operation and at the end of operation.The postoperative indexes of the two groups were compared.The analgesic effects of the two groups at 6 h,12 h,24 h and 48 h after operation[numerical rating scale(NRS)],the cognitive function of the 2 groups at 1 d before operation,1 d after operation,3 d after operation and 5 d after operation[mini-mental state examination(MMSE)and Montreal cognitive scale(MoCA)],and the adverse reactions of the 2groups were counted.Results The HR and MAP of the 2 groups from the time of entering the room to the end of the operation showed a trend of decreasing first and then increasing,and the fluctuation of the observation group was smaller.There were statistical significant differences between the groups,time points and groups·time points(P<0.05).The dosage and number of PCA compressions in the observation group were lower than those of the control group(P<0.05).The NRS scores of the 2 groups from 6h to 48 h after operation showed a trend of increasing first and then decreasing.There were statistical significant differences between groups,time points and groups·time points(P<0.05).The MMSE score and MoCA score of the 2 groups from 1 day to 5 days after operation showed a trend of decreasing first and then increasing.There were statistical significant diff

关 键 词：肺癌根治术 静吸复合麻醉 超声引导 星状神经节阻滞 血流动力学 

分 类 号：R734.2[医药卫生—肿瘤]