| 摘要: |
| 目的：探讨老年肺癌患者开胸手术治疗时选用超声引导下胸椎旁神经阻滞全麻的效果及对患者认知功能产生的影响。方法：选取2015年1月-2018年12月在本院治疗的80例肺癌老年患者分为2组,麻醉前,观察组(n=40)行超声引导下胸椎旁神经阻滞,对照组(n=40)行硬膜外阻滞,观察患者血流动力学变化、术后疼痛及认知功能状况等。结果：T2～T5几个时间点,观察组患者MAP、HR均显著低于对照组(P＜0.05),2组T1时MAP、HR比较无显著差异(P＞0.05)；停药后,观察组患者恢复自主呼吸、吞咽、呼之睁眼平均时间均显著短于对照组(P＜0.05)；2组患者术后6h、12h、24h及48h时VAS评分对比均无明显差异(P＞0.05)；2组患者术前、术后48h时MMSE评分对比无显著差异(P＞0.05),术后1h、6h、24h时,观察组MMSE评分显著高于对照组(P＜0.05)。结论：肺癌患者开胸手术治疗时,选用超声引导下胸椎旁神经阻滞,可使患者血流动力学保持良好稳定性,镇痛效果较理想,且不会对患者术后认知功能产生显著影响。 |
| 关键词: 肺癌 开胸手术 麻醉 硬膜外阻滞 胸椎旁神经阻滞 |
| DOI： |
| 投稿时间：2019-04-05修订日期：2019-04-05 |
| 基金项目: |
|
| Ultrasound-guided thoracic paravertebral nerve block in elderly patients with lung cancer undergoing thoracotomy and its effect on postoperative cognitive function |
| lianglei |
| () |
| Abstract: |
| Objective: To evaluate the effect of ultrasound-guided thoracic paravertebral nerve block anesthesia on cognitive function in elderly patients with lung cancer undergoing thoracotomy.Methods:80 elderly patients with lung cancer treated in our hospital from January 2015 to December 2018 were divided into two groups,before anesthesia, the observation group (n=40) received ultrasound-guided paravertebral nerve block, while the control group (n=50) received epidural block,hemodynamic changes, postoperative pain and cognitive function were observed.Results:At the time points of T2-T5, MAP and HR in the observation group were significantly lower than those in the control group(P＜0.05),there was no significant difference in MAP and HR at T1 between the two groups(P＞0.05);After withdrawal, the average time for patients in the observation group to resume spontaneous breathing, swallowing and breathing was significantly shorter than that in the control group(P＜0.05);There was no significant difference in VAS score between the two groups at 6, 12, 24 and 48 hours after operation(P＞0.05);There was no significant difference in MMSE score between the two groups before and 48 hours after operation(P＞0.05),at 1h, 6h and 24h after operation, the MMSE score of observation group was significantly higher than that of control group(P＜0.05).Conclusion:When patients with lung cancer undergo thoracotomy,uitrasound-guided paravertebral nerve block was used,can keep the hemodynamics of patients in good stability, and the analgesic effect is ideal, and it will not have a significant impact on the cognitive function of patients after operation. |
| Key words: Lung cancer Thoracic surgery Anesthesia Epidural block Thoracic paravertebral nerve block |
