椎旁神经阻滞复合全麻对多发肋骨骨折手术患者应激反应及炎症反应的影响  

The Effect of Paravertebral Nerve Block Combined with General Anesthesia on Stress Response and Inflammatory Response in Patients with Multiple Rib Fracture Surgery

作　　者：梁文娟 杨盛兵 王浩 LIANG Wenjuan;YANG Shengbing;WANG Hao(Department of Anesthesiology,Qiandongnan People's Hospital,Qiandongnan Miao and Dong Autonomous Prefecture,Guizhou,556000,China)

机构地区：[1]黔东南州人民医院手术麻醉科,贵州黔东南苗族侗族自治州556000

出　　处：《中外医疗》2025年第8期44-47,共4页China & Foreign Medical Treatment

摘　　要：目的探讨椎旁神经阻滞复合全麻对多发肋骨骨折手术患者的影响。方法随机选取2022年3月—2024年3月黔东南州人民医院收治的100例多发肋骨骨折手术患者为研究对象,根据不同麻醉方法分组。对照组(50例)予以全身麻醉,观察组(50例)予以椎旁神经阻滞复合全麻。对比两组炎性反应、应激反应、疼痛程度。结果术后2 h,观察组肿瘤坏死因子-α水平为(7.66±1.92)pg/mL、中性粒细胞弹性蛋白酶水平为(60.21±15.33)ng/mL、白细胞介素-6水平为(9.87±2.04)pg/mL,均低于对照组的(10.03±2.16)pg/mL、(70.66±18.17)ng/mL、(13.52±3.66)pg/mL,差异均有统计学意义(t=5.799,3.108,6.160;P均<0.05)。术后2 h,观察组的应激反应指标低于对照组,差异均有统计学意义(P均<0.05)。术后2 h、12 h、48 h,观察组视觉模拟量表评分均低于对照组,差异均有统计学意义(P均<0.05)。结论在多发肋骨骨折手术患者中应用椎旁神经阻滞复合全麻效果显著,可有效减轻应激反应,缓解炎症,且镇痛效果较好。Objective To investigate the effect of paravertebral nerve block combined with general anesthesia on patients with multiple rib fractures.Methods A total of 100 patients with multiple rib fractures admitted to Qiandongnan People's Hospital from March 2022 to March 2024 were randomly selected as the research objects and grouped according to different anesthesia methods.The control group(50 cases)was given general anesthesia,and the observation group(50 cases)was given paravertebral nerve block combined with general anesthesia.The inflammatory response,stress response and pain degree of the two groups were compared.Results At 2 h after operation,the levels of tumor necrosis factor-α(7.66±1.92)pg/mL,neutrophil elastase(60.21±15.33)ng/mL and interleukin-6(9.87±2.04)pg/mL in the observation group were lower than those in the control group(10.03±2.16)pg/mL,(70.66±18.17)ng/mL and(13.52±3.66)pg/mL,the differences were statistically significant(t=5.799,3.108,6.160;all P<0.05).At 2 h after operation,the stress response index of the observation group was lower than that of the control group,and the difference was statistically significant(all P<0.05).At 2 h,12 h and 48 h after operation,the scores of Visual Analogue Scale in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).Conclusion The application of paravertebral nerve block combined with general anesthesia in patients with multiple rib fracture surgery has a significant effect,which can effectively reduce stress response,relieve inflammation,and has a good analgesic effect.

关 键 词：多发肋骨骨折 手术 全身麻醉 椎旁神经阻滞 炎症反应 应激反应 

分 类 号：R614[医药卫生—麻醉学]