胸椎旁神经阻滞辅助全麻在肺癌根治术中的应用研究  

Application of Thoracic Paravertebral Nerve Block Assisted General Anesthesia in Radical Surgery for Lung Cancer

作　　者：张真 Zhang Zhen(Department of Anesthesiology and Perioperative Medicine,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou,Henan,450000,China)

机构地区：[1]郑州大学附属郑州中心医院麻醉与围术期医学科,河南郑州450000

出　　处：《黑龙江医学》2025年第5期524-527,共4页Heilongjiang Medical Journal

摘　　要：目的:观察胸椎旁神经阻滞(TPVB)辅助全麻在肺癌根治术中的应用效果。方法:选取2022年10月—2023年11月郑州大学附属郑州中心医院收治的100例肺癌根治术患者作为研究对象,研究方法为前瞻性研究,通过电脑随机分组将患者分为常规组(50例)和联合组(50例)。常规组采用常规全麻辅助手术,联合组采用TPVB联合全麻辅助手术,比较两组患者围手术期基础体征,术后镇痛、镇静情况,麻醉恢复情况,手术应激反应及麻醉安全性。结果:切皮时,联合组心率(HR)及平均动脉压(MAP)均低于常规组,差异均有统计学意义(t=2.398、3.699,P<0.05);术后1 h、3 h,联合组视觉模拟量表(VAS)评分均低于常规组,Ramsay镇静评分(RSS)均高于常规组,差异均有统计学意义(t=2.294、4.714、7.085、15.807,P<0.05);联合组睁眼时间、PACU停留时间、转入普通病房时间、住院时间高于常规组,差异均无统计学意义(t=0.717、0.992、1.152、0.596,P>0.05);术后,两组患者均有一定手术应激反应,但联合组的去甲肾上腺素(NE)、皮质醇(Cor)水平均低于常规组,差异均有统计学意义(t=3.655、3.726,P<0.05);联合组的麻醉相关副反应发生率高于常规组,差异无统计学意义(χ^(2)=0.889,P>0.05)。结论:TPVB辅助全麻能有效稳定肺癌根治术患者围手术期基础体征,可在不影响麻醉苏醒情况的同时,增强术后镇痛、镇静效果并减轻手术应激,且安全性较高。Objective:To observe the application effect of TPVB assisted general anesthesia in radical lung cancer surgery.Methods:The subjects of this study were 100 patients with radical resection of lung cancer admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from October 2022 to November 2023.The study method was a prospective study,and the patients were divided into the routine group(50 cases)and the combined group(50 cases)by computer randomization.The conventional group was treated with general anesthesia,and the combined group was treated with TPVB combined with general anesthesia.The perioperative basic signs,postoperative analgesia,sedation,anesthesia recovery,surgical stress reaction and anesthesia safety were compared between the two groups.Results:When peeling,HR and MAP in combination group were lower than those in conventional group,with statistically significant difference(t=2.398,3.699;P<0.05).1 h and 3 h after operation,VAS score and RSS score of combination group were lower than those of conventional group,and the differences were statistically significant(t=2.294,4.714,7.085,15.807;P<0.05).The eye opening time,PACU stay time,time transferred to the general ward and hospital stay in the combined group were higher than those in the conventional group,with no statistically significant difference(t=0.717,0.992,1.152,0.596;P>0.05).After surgery,both groups had some surgical stress reactions,but the NE and Cor of the combined group were lower than those of the conventional group,the differences were statistically significant(t=3.655,3.726;P<0.05).The incidence of anesthesia-related side effects in combination group was higher than that in conventional group,and the difference was not statistically significant(χ^(2)=0.889,P>0.05).Conclusion:TPVB assisted general anesthesia can effectively stabilize the perioperative basic signs of patients undergoing radical resection of lung cancer,enhance postoperative analgesia and sedation,and relieve surgical stress without affecting anesthesia rec

关 键 词：肺癌根治术 全身麻醉 胸椎旁神经阻滞 麻醉效果 麻醉安全性 

分 类 号：R734.2[医药卫生—肿瘤]