摘要
目的:分析幕上肿瘤切除术中超声引导头部神经阻滞对患者认知功能和睡眠质量的影响。方法:选取2020年2月-2021年2月中国人民解放军联勤保障部队第九○○医院的86例幕上肿瘤切除术患者为研究对象。采用随机数字表法将患者分为A组和B组,各43例。A组采用全麻,B组采用超声引导头部神经阻滞联合全麻。比较两组的血流动力学指标(平均动脉压、心率)、疼痛程度(VAS评分)、认知功能(MMSE评分)、睡眠质量(PSQI评分)以及不良反应(恶心呕吐、头晕、尿潴留、呼吸抑制)发生情况。结果:B组插管后、上头钉时、切皮时、切瘤时、缝皮后的平均动脉压均高于A组,心率均低于A组,差异均有统计学意义(P<0.05)。A组插管后、上头钉时、切皮时、切瘤时、缝皮后的平均动脉压均低于麻醉前,心率均高于麻醉前,差异均有统计学意义(P<0.05)。B组插管后的平均动脉压低于麻醉前,插管后、上头钉时、切皮时、切瘤时的心率均高于麻醉前,差异均有统计学意义(P<0.05)。B组术后2、6、12、24、48 h的VAS评分均低于A组,差异均有统计学意义(P<0.05)。B组术后1、3、7 d的MMSE评分均高于A组,PSQI评分均低于A组,差异均有统计学意义(P<0.05)。A组术后1、3、7 d的MMSE评分均低于术前,PSQI评分均高于术前,差异均有统计学意义(P<0.05);B组术后1、3 d的MMSE评分低于术前,差异均有统计学意义(P<0.05)。B组术后1 d的PSQI评分高于术前,术后7 d的PSQI评分低于术前,差异均有统计学意义(P<0.05)。B组的不良反应发生率低于A组,差异有统计学意义(P<0.05)。结论:幕上肿瘤切除术中超声引导头部神经阻滞的应用效果显著,可稳定术中血流动力学指标,减轻术后疼痛以及全麻对患者认知功能与睡眠质量的影响,且能降低不良反应发生率,有效性与安全性均较好,值得推广。
Objective:To analyze the effects of ultrasound-guided head nerve block on cognitive function and sleep quality in patients undergoing supratentorial tumor resection.Method:A total of 86 patients undergoing supratentorial tumor resection in the No.900 Hospital of PLA Joint Logistic Support Force from February 2020 to February 2021 were selected as the research subjects.The patients were divided into group A and group B by random number table method,43 cases in each group.Group A was given general anesthesia,group B was given ultrasound-guided head nerve block combined with general anesthesia.Hemodynamic indexes (arterial pressure,heart rate),pain degree (VAS score),cognitive function (MMSE score),sleep quality (PSQI score) and adverse reactions (nausea and vomiting,dizziness,urinary retention,respiratory depression) were compared between the two groups.Result:The mean arterial pressure of group B after intubation,head nail,skin resection,tumor resection and skin suture were higher than those of group A,the heart rate were lower than those of group A,the differences were statistically significant (P<0.05).The mean arterial pressure of group A after intubation,head nail,skin cutting,tumor cutting and skin sewing were lower than those before anesthesia,the heart rate were higher than those before anesthesia,the differences were statistically significant (P<0.05).In group B,the mean arterial pressure after intubation was higher than that before anesthesia,the heart rate after intubation,during head nail,skin cutting and tumor cutting were higher than those before anesthesia,the differences were statistically significant (P<0.05).VAS scores of group B were lower than group A at 2,6,12,24 and 48 h after surgery,the differences were statistically significant (P<0.05).The MMSE scores of group B at 1,3 and 7 d after surgery were higher than those of group A,the PSQI scores of group B were lower than those of group A,the differences were statistically significant (P<0.05).The MMSE scores of group A at 1,3 and 7 d after surgery were lower than those before surgery,the PSQI scores were higher than those before surgery,the differences were statistically significant (P<0.05).The MMSE score of group B at 1 and 3 d after surgery were lower than those before surgery,the differences were statistically significant (P<0.05).The PSQI score of group B at 1 d after surgery was higher than that before surgery,at 7 d after surgery was lower than that before surgery,the differences were statistically significant (P<0.05).The incidence of adverse reactions in group B was lower than that in group A,the difference was statistically significant (P<0.05).Conclusion:The application of ultrasound-guided head nerve block in supratentorial tumor resection has a significant effect,which can stabilize intraoperative hemodynamic indexes,alleviate postoperative pain,and reduce the effect of general anesthesia on patients’ cognitive function and sleep quality,and can reduce the incidence of adverse reactions,it is both effective and safe,and is worthy of promotion.
作者
刘鸽
赖峻松
李敏
谢红梅
LIU Ge;LAI Junsong;LI Min;XIE Hongmei(No.900 Hospital of PLA Joint Logistic Support Force,Fuzhou 350001,China)
出处
《中国医学创新》
CAS
2021年第23期14-18,共5页
Medical Innovation of China
关键词
幕上肿瘤切除术
超声引导
头部神经阻滞
认知功能
睡眠质量
Supratentorial tumor resection
Ultrasound-guidance
Head nerve block
Cognitive function
Sleep quality
