摘要
目的:观察胸椎旁神经阻滞(TPVB)对腹腔镜胆囊切除手术(LC)患者的心肌保护作用和对白细胞介素-6(IL-6)和白细胞介素-1β(IL-1β)的影响。方法:选取2022年6月—2023年4月样本医院行LC的60例成年患者作为研究对象,采用随机数表法将其分为TPVB复合全身麻醉组(T组,30例)和全身麻醉组(G组,30例)。T组全身麻醉诱导前在超声引导下行双侧椎旁神经阻滞(T8~T9椎体),阻滞成功后行全身麻醉诱导,G组单纯行全身麻醉。维持两组患者的血流动力学平稳并持续监测呼气末二氧化碳分压。所有患者于T_(0)(麻醉前5 min)、T_(1)(手术结束时)、T_(2)(术后24 h)和T_(3)(术后48 h)抽取静脉血3 mL检测血清中心肌肌钙蛋白Ⅰ(cTnI)、心肌肌酸激酶同工酶(CK-MB)、IL-6和IL-1β的变化情况(ELISA法)。结果:在T_(1)~T_(3)时,T组的各项指标的上升程度明显低于G组,差异有统计学意义(P<0.05);T组术后数字评分量表评分、瑞芬太尼用量、镇痛泵有效按压次数和术后恶心呕吐例数比G组明显降低,差异有统计学意义(P<0.05)。结论:TPVB对于LC患者有心肌保护作用。
Objective:To compare the effects of combined thoracic paravertebral blocked and general anesthesial on myocardial protection,IL-6 and IL-1βin patients undergoing laparoscopic cholecystectomy.Methods:Patients were selected from June 2020 to February 2022.All patients were randomly divided into group T(received thoracic paravertebal blocked combined general anesthesial,n=30)and group G(general anesthesial,n=30).Bilateral paravertebral nerve block(T8~T9)under ultrasound guidance was performed in group T before general anesthesia induction,and general anesthesia induction was performed in group G after successful anesthesia induction.Hemodynamic stability was maintained,and end-expiratory carbon dioxide was continuously monitored in both groups.3 mL of venous blood was collected at T_(0)(5 min before anesthesia),T_(1)(at the end of surgery),T_(2)(24 h after surgery)and T_(3)(48 h after surgery)to detect the changes of serum cardiac troponinⅠ(cTnI),myocardial creatine kinase isoenzyme(CK-MB),IL-6 and IL-1β(ELISA).Results:At T_(1)~T_(3),the increase degree of various indexes in group T was significantly lower than that in group G,and the difference was statistically significant(P<0.05).The NRS score,remifentanil dosage,the number of effective analgesic pump compression and the number of postoperative nausea and vomiting cases in T group were significantly lower than those in G group,with statistically significant difference(P<0.05).Conclusion:TPVB has myocardial protection in LC patients.
作者
陈西艳
张茂银
Chen Xiyan;Zhang Maoyin(Department of Anesthesiology,Tongshan District People’s Hospital of Xuzhou,Xuzhou,Suzhou,221006,China;不详)
出处
《黑龙江医学》
2024年第17期2081-2083,2087,共4页
Heilongjiang Medical Journal
