超声引导下腹横肌平面阻滞联合氢吗啡酮在老年腹腔镜结肠癌根治术患者中的应用效果OA
Application Effect of Ultrasound-guided Transverse Abdominal Muscle Plane Block Combined with Hydromorphone in Elderly Patients Undergoing Laparoscopic Radical Resection of Colon Cancer
目的:探讨超声引导下腹横肌平面(TAP)阻滞联合氢吗啡酮在老年腹腔镜结肠癌根治术患者中的应用效果.方法:选取 2021 年 1 月—2023 年 12 月北京市昌平区医院收治的 120 例老年腹腔镜结肠癌根治术患者作为研究对象.根据随机数表法将其分为参考组和试验组,各 60 例.两组均给予全身麻醉,参考组给予氢吗啡酮镇痛泵,试验组在参考组基础上给予超声引导下TAP阻滞.比较两组术后 1 h、12 h、24 h疼痛程度,术前、术后 1 h和术后 24 h应激指标,术前、术后1 h和术后 48 h的心率(HR)和平均动脉压(MAP),以及不良反应.结果:术后 12 h、24 h,两组视觉模拟评分法(VAS)评分均低于术后 1 h,试验组VAS评分低于参考组,差异有统计学意义(P＜0.05).术后 1 h、24 h,两组去甲肾上腺素(NE)及皮质醇(Cor)水平均较术前高,术后 24 h,两组NE及Cor水平均较术后 1 h低,且试验组NE及Cor水平均低于参考组,差异有统计学意义(P＜0.05).术后 1 h、48 h,两组HR和MAP水平均较术前明显高,术后 48 h,两组HR和MAP均较术后 1 h低,且试验组MAP、HR均低于参考组,差异有统计学意义(P＜0.05).两组不良反应发生率比较,差异无统计学意义(P＞0.05).结论:超声引导下TAP阻滞联合氢吗啡酮能够促进老年腹腔镜结肠癌根治术患者术后疼痛缓解,减轻患者术后应激反应,稳定血流动力学,且具备较好的安全性.
Objective:To investigate the application effect of ultrasound-guided transverse abdominal muscle plane(TAP)block combined with Hydromorphone in elderly patients undergoing laparoscopic radical resection of colon cancer.Method:A total of 120 elderly patients undergoing laparoscopic radical resection of colon cancer treated in Beijing Changping District Hospital from January 2021 to December 2023 were selected as the study objects.According to the random number table method,they were divided into reference group and experimental group,with 60 cases in each group.Both groups were given general anesthesia,the reference group was given Hydromorphone analgesic pump,and the experimental group was given ultrasound-guided TAP block based on the reference group.Pain degree at 1 h,12 h and 24 h after surgery,stress index before surgery,1 h and 24 h after surgery,heart rate(HR)and mean arterial pressure(MAP)before surgery,1 h and 48 h after surgery,and adverse reactions were compared between the two groups.Result:At 12 h and 24 h after surgery,VAS scores of both groups were lower than those of 1 h after surgery,and VAS scores of the experimental group were lower than those of the reference group,the differences were statistically significant(P＜0.05).The levels of norepinephrine(NE)and cortisol(Cor)in the two groups 1 h and 24 h after surgery were higher than those before surgery,at 24 h after surgery,the levels of NE and Cor in both groups were lower than those in 1 h after surgery,and the levels of NE and Cor in the experimental group were lower than those in the reference group,the differences were statistically significant(P＜0.05).At 1 h and 48 h after surgery,HR and MAP levels in both groups were significantly higher than those before surgery,at 48 h after surgery,HR and MAP levels in both groups were lower than those in 1 h after surgery,and MAP and HR levels in the experimental group were lower than those in the reference group,the differences were statistically significant(P＜0.05).The incidence of adverse reactions was compared between the two groups(P＞0.05).Conclusion:Ultrasound-guided TAP block plus Hydromorphone can promote postoperative pain relief,reduce postoperative stress response,stabilize hemodynamics,and have good safety in elderly patients undergoing laparoscopic radical colon cancer surgery.
钱婧
北京市昌平区医院 北京 102200
腹腔镜结肠癌根治术老年超声腹横肌平面阻滞氢吗啡酮应激指标
Laparoscopic radical resection of colon cancerElderlyUltrasoundTransversal plane blockHydromorphoneStress response
《中外医学研究》 2024 (035)
14-18 / 5
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