超声引导下胸椎旁神经阻滞复合全麻对行胸腔镜下肺叶切除术老年患者认知功能障碍的影响研究  

Effect of Ultrasound-guided Thoracic Paravertebral Nerve Block Combined with General Anesthesia on Cognitive Impairment in Elderly Patients Undergoing Thoracoscopic Lobectomy

作　　者：任燕 李福森[1] 杨云[1] Ren Yan;Li Fushen;Yang Yun(Anesthesia and Perioperative Medicine Department,Xinxiang Central Hospital,Xinxiang,Henan,453000,China)

机构地区：[1]新乡市中心医院麻醉与围术期医学科,河南新乡453000

出　　处：《黑龙江医学》2025年第8期951-953,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨超声引导下胸椎旁神经阻滞(CTPVB)复合全麻对行胸腔镜下肺叶切除术老年患者认知功能障碍(POCD)的影响。方法:选取2021年3月—2023年3月新乡市中心医院收治的70例行胸腔镜下肺叶切除术的老年患者作为研究对象,根据随机数表法将其分为对照组和观察组,每组各35例。对照组患者采用单纯全麻,观察组患者采用CTPVB复合全麻。比较两组患者POCD发生率、认知功能及腺苷二磷酸(ADP)水平。结果:术后24 h,观察组患者POCD发生率为5.71%(2/35),低于对照组的25.71%(9/35),差异有统计学意义(χ^(2)=5.285,P<0.05)。术后12 h、24 h、48 h,观察组患者简易智力状态检查量表(MMSE)评分高于对照组,差异均有统计学意义(t=65.244、52.874、59.531,P<0.05)。切片后15 min、术后7 d,观察组患者ADP水平高于对照组,差异均有统计学意义(t=59.841、76.305,P<0.05)。结论:行胸腔镜下肺叶切除术老年患者实施CTPVB复合全麻效果更佳,对患者的认知功能影响小,POCD发生率低,ADP水平波动小。Objective:To investigate the effect of ultrasound-guided thoracic paravertebral block(CTPVB)combined with general anesthesia in elderly patients with thoracoscopic lobectomy.Methods:70 elderly patients undergoing thoracoscopic lobectomy in the hospital from March 2021 to March 2023 were divided into two groups according to the random number table method,with 35 cases in each group.The control group was given simple general anesthesia,and the observation group was given CTPVB combined with general anesthesia.The incidence of postoperative cognitive dysfunction(POCD),cognitive function and adiponectin(ADP)levels were compared between the two groups.Results:The incidence of POCD in the observation group was 5.71%(2/35)24 h after operation,which was lower than 25.71%(9/35)in the control group(χ^(2)=5.285,P<0.05).The MMSE scores of the observation group 12 h,24 h and 48 h after operation were higher than those of the control group(t=65.244,52.874,59.531;P<0.001).15 min after biopsy,the levels of ADP in the two groups decreased,but the levels of ADP in the observation group were higher than those in the control group(t=59.841,76.305;P<0.001).Conclusion:CTPVB combined with general anesthesia is more effective in elderly patients undergoing thoracoscopic lobectomy,with less impact on cognitive function,lower incidence of POCD,and smaller fluctuation of ADP level.

关 键 词：胸腔镜下肺叶切除术 超声引导下胸椎旁神经阻滞 全麻 认知功能 

分 类 号：R614[医药卫生—麻醉学]