摘要
目的分析全腔镜食管癌病患手术过程中使用亚甲蓝以及罗哌卡因进行肋间神经阻滞的作用。方法选择在本院实施全腔镜食管癌手术治疗的68例病患为研究样本,其研究时间均在2020年6月至2020年12月之间,采取随机数字排列表法将其分成常规组(34例)以及实验组(34例)。其中常规组病患使用罗哌卡因进行肋间神经阻滞,实验组病患在手术过程中实施亚甲蓝以及罗哌卡因肋间神经阻滞。对比每组病患手术时间以及手术过程中出血量;手术过程中低血压以及心律失常出现率;手术后机械通气时间、首次下床活动时间、胸管拔除时间以及住院时间;肺部并发症出现率;手术后第1天、第3天、第7天以及第15天时视觉模拟评分法(visual analogue scale,VAS)得分。结果两组病患手术时间以及手术过程中出血量比较,差异无统计学意义(P>0.05)。两组病患手术过程中低血压以及心律失常出现率比较,差异无统计学意义(P>0.05)。实验组病患手术后机械通气时间、首次下床活动时间、胸管拔除时间以及住院时间均短于常规组,差异有统计学意义(P<0.05)。实验组病患胸腔积液以及肺部感染出现率均低于常规组,差异有统计学意义(P<0.05)。手术后第1天、第3天以及第7天时,实验组病患VAS得分均低于常规组,差异有统计学意义(P<0.05)。手术后第15天时两组病患VAS得分比较,差异无统计学意义(P>0.05)。结论全腔镜食管癌手术快速康复中实施亚甲蓝以及罗哌卡因肋间神经阻滞,缩短机械通气时间、首次下床活动时间、胸管拔除时间以及住院时间,改善术后早期疼痛感,减少肺部并发症,促进腔镜食管癌手术患者快速康复。
Objective To study the rehabilitation effects of intercostal nerve blocking with methylene blue and ropivacaine for esophageal cancer patients using the totally laparoscopic surgery. Methods 68 esophageal cancer patients of undergoing the totally laparoscopic surgery from June 2020 to December 2020 in our hospital were selected as research samples. According to random permutation table, patients were divided into routine group(34 cases) and test group(34 cases). The routine group took the intercostal nerve blocking with ropivacaine;the test group took the intercostal nerve blocking with methylene blue and ropivacaine. Patients were investigated through the comparative analysis results of operation time, intraoperative bleeding volume, incidences of hypotension and arrhythmia, postoperative ventilation duration, initial ambulant time, extubation time and hospital stays, occurrences of pulmonary complications as well as visual analogue scale(VAS) scores after 1 d, 3 d, 7 d and 15 d of surgery. Results There were no significant between-group differences about the operation time and intraoperative bleeding volume(P>0.05);there were no significant between-group differences about the incidences of hypotension and arrhythmia(P> 0.05);the postoperative ventilation duration, initial ambulant time, extubation time and hospital stays in the test group were shorter than those in the routine group, with statistically significant difference(P< 0.05);the occurrences of pleural effusion and lung infection in the test group were lower than those in the routine group, with statistically significant difference(P<0.05);after 1 d, 3 d and 7 d of surgery, VAS scores in the test group were lower than those in the routine group, with statistically significant difference(P<0.05);after 15 d of surgery, there were no significant between-group differences about VAS scores(P>0.05). Conclusion The intercostal nerve blocking with methylene blue and ropivacaine can shorten the postoperative ventilation duration, initial ambulant time, extubation time and hospital stays, reduce the early pain degree and pulmonary complications and promote the fast rehabilitation.
作者
蓝聪
李晓军
林万里
何海权
彭枫源
张海
LAN Cong;LI Xiao-jun;LIN Wan-li;HE Hai-quan;PENG Feng-yuan;ZHANG Hai(Thoracic Surgery Department,the People's Hospital of Gaozhou,Gaozhou,Guangdong 525200)
出处
《智慧健康》
2021年第17期172-175,共4页
Smart Healthcare
基金
广东省茂名市科技计划项目(项目编号:2020154)。
关键词
快速康复
食管癌
肋间神经阻滞
罗哌卡因
亚甲蓝
Fast rehabilitation
Esophageal cancer
Intercostal nerve blocking
Ropivacaine
Methylene blue
