超声引导下连续竖脊肌平面阻滞对中低位直肠癌患者应激及免疫功能的影响  

Effects of ultrasound-guided continuous erector spinal plane block on postoperative stress and immune function in middle and low rectal cancer

作　　者：赵灿 ZHAO Can(Department of Anesthesiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院麻醉科,郑州450052

出　　处：《中国免疫学杂志》2025年第4期954-958,966,共6页Chinese Journal of Immunology

摘　　要：目的:探讨超声引导下连续竖脊肌平面阻滞对中低位直肠癌患者应激及免疫功能的影响。方法:选取2020年6月至2022年3月郑州大学第一附属医院收治的中低位直肠癌患者80例作为研究对象,随机分为实验组(40例)和对照组(40例),实验组患者采取超声引导下连续竖脊肌平面阻滞复合全身麻醉,对照组单纯进行全身麻醉。比较两组患者一般资料、镇痛效果、术后不良反应和恢复情况,记录并比较患者不同时间点应激反应问卷(SRQ)评分、免疫功能指标、肾上腺素(E)、去甲肾上腺素(NE)水平变化。结果:对照组患者情绪、行为、躯体反应评分均显著高于实验组(P<0.05,FDR校正);术毕(T1)、术后24 h(T2)、术后72 h(T3)实验组患者CD3^(+)T、CD4^(+)T、CD8^(+)T、CD4^(+)T/CD8^(+)T、NK细胞、IL-6、IL-10、TNF-α明显低于对照组,而IL-2明显高于对照组(P<0.05,FDR校正);T1、T2、T3时对照组患者NE和E水平均显著高于实验组(P<0.05,FDR校正);实验组患者术后不良反应发生率显著低于对照组,且术后各项恢复指标均优于对照组患者(P<0.05,FDR校正)。结论:超声引导下连续竖脊肌平面阻滞在中低位直肠癌手术中能够减缓患者术后应激反应,提升术后免疫功能,增强镇痛效果,降低不良反应发生率并提高患者术后恢复能力。Objective:To investigate effects of ultrasound-guided continuous erector spinal plane block on postoperative stress and immune function in middle and low rectal cancer.Methods:A total of 80 patients with middle and low rectal cancer who were admitted to the First Affiliated Hospital of Zhengzhou University from June 2020 to March 2022 were selected as research objects,and divided into experimental group(40 cases)and control group(40 cases)randomly.Patients in experimental group received ultrasound-guided continuous erector spinal plane block combined with general anesthesia,and patients in control group received general anesthesia alone.General information,analgesic effect,postoperative adverse reactions and recovery of patients in two groups were compared.Stress response questionnaire(SRQ)score,immune function indexes,changes of adrenaline(E)and norepinephrine(NE)levels of patients at different time points were recorded and compared.Results:Scores of emotion,behavior and body response in control group were significantly higher than experimental group(P<0.05,FDR corrected).CD3^(+)T,CD4^(+)T,CD8^(+)T,CD4^(+)T/CD8^(+)T,NK cells,IL-6,IL-10 and TNF-αin experimental group were significantly lower than control group at the end of operation(T1),24 h after operation(T2)and 72 h after operation(T3),while IL-2 was significantly higher than control group(P<0.05,FDR correction).At T1,T2 and T3,levels of NE and E in control group were significantly higher than experimental group(P<0.05,FDR correction).Incidence of postoperative adverse reactions in experimental group was significantly lower than control group,and all postoperative recovery indicators were better than control group(P<0.05,FDR corrected).Conclusion:Ultrasound-guided continuous erector spinal plane block can alleviate postoperative stress response,improve postoperative immune function,enhance analgesia effect,reduce incidence of adverse reactions and improve postoperative recovery ability of patients in middle and low rectal cancer surgery.

关 键 词：连续竖脊肌平面阻滞 中低位直肠癌 应激 

分 类 号：R614[医药卫生—麻醉学]