超声引导胸椎旁神经阻滞联合全麻在肺癌胸腔镜手术中的应用效果分析  

Application Effect Analysis of Ultrasound-guided Thoracic Paravertebral Nerve Block Combined with General Anesthesia in Thoracoscopic Surgery for Lung Cancer

作　　者：姜素莉 方洁[1] JIANG Suli;FANG Jie(The First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou,450000)

机构地区：[1]河南中医药大学第一附属医院,450000

出　　处：《实用癌症杂志》2025年第3期448-451,共4页The Practical Journal of Cancer

摘　　要：目的 探讨超声引导胸椎旁神经阻滞(TPVB)联合全麻在肺癌胸腔镜手术中的应用效果。方法 选取行胸腔镜手术的74例肺癌患者,依据是否实施了胸椎旁神经阻滞划分成两组,每组各37例。对照组予以全身麻醉,观察组予以全身麻醉联合胸椎旁神经阻滞。对比两组术中血流动力学、术毕清醒时间、术后疼痛程度、炎症因子水平、不良反应。结果 麻醉前(T0),两组心率(HR)、平均动脉压(MAP)相比,无统计学差异(P>0.05);切皮即刻(T1)、人工气胸30 min(T2),观察组HR、MAP均低于对照组,有统计学差异(P<0.05);观察组术毕清醒时间短于对照组,术后不良反应发生率低于对照组,有统计学差异(P<0.05);术后6 h、12 h、24 h观察组视觉模拟疼痛量表(VAS)评分低于对照组,有统计学差异(P<0.05);术前两组白介素-6(IL-6)、白介素-10(IL-10)相比,无统计学差异(P>0.05);术后24 h观察组IL-6、IL-10均低于对照组,有统计学差异(P<0.05)。结论 胸椎旁神经阻滞联合全麻在肺癌胸腔镜手术中效果确切,可更加有效地维持术中血流动力学稳定,缩短术毕清醒时间,减轻患者术后疼痛及机体炎症反应,且不良反应较少,临床应用价值较高。Objective To investigate the application effect of ultrasound-guided thoracic paravertebral nerve block(TPVB)combined with general anesthesia in thoracoscopic surgery for lung cancer.Methods 74 lung cancer patients who underwent thoracoscopic surgery were selected and divided into 2 groups based on whether thoracic paravertebral nerve block was performed,with 37 patients in each group.The control group received general anesthesia,while the observation group received general anesthesia combined with thoracic paravertebral nerve block.Compare the intraoperative hemodynamics,postoperative recovery time,postoperative pain level,inflammatory factor levels,and adverse reactions between 2 groups.Results Before anesthesia(T0),there was no statistically significant difference in heart rate(HR)and mean arterial pressure(MAP)between the two groups(P>0.05);Immediately after skin incision(T1)and 30 minutes after artificial pneumothorax(T2),the HR and MAP of the observation group were lower than those of the control group(P<0.05);The observation group had a shorter postoperative awakening time and a lower incidence of adverse reactions compared to the control group(P<0.05);The visual analog pain scale(VAS)scores of the observation group were lower than those of the control group at 6,12,and 24 hours after surgery(P<0.05);There was no statistically significant difference(P>0.05)in the levels of interleukin-6(IL-6)and interleukin-10(IL-10)between the 2 groups before surgery;24 hours after surgery,the levels of IL-6 and IL-10 in the observation group were lower than those in the control group(P<0.05).Conclusion The combination of thoracic paravertebral nerve block and general anesthesia is effective in thoracoscopic surgery for lung cancer.It can more effectively maintain hemodynamic stability during surgery,shorten the time of postoperative awakening,alleviate postoperative pain and inflammatory reactions in patients,and has fewer adverse reactions.It has high clinical application value.

关 键 词：肺癌 胸腔镜手术 胸椎旁神经阻滞 全麻 不良反应 

分 类 号：R734.2[医药卫生—肿瘤]