| 术前超声引导下单次腰方肌阻滞对胃癌根治术患者早期康复及T细胞免疫功能的影响 |
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| 引用本文： | 周波,毛晓丽,胡磊.术前超声引导下单次腰方肌阻滞对胃癌根治术患者早期康复及T细胞免疫功能的影响[J].中国癌症防治杂志,2019,11(4):318-322. |
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| 作者姓名： | 周波 毛晓丽 胡磊 |
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| 作者单位： | 武汉中医医院超声科 |
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| 摘 要： | 目的 探讨术前超声引导下单次腰方肌阻滞对胃癌根治术患者早期康复及T细胞免疫功能的影响。方法 选取2017年3月至2018年6月于我院行胃癌根治手术的68例患者作为研究对象，采用随机数字表法分为观察组（n=34）和对照组（n=34），观察组在麻醉诱导后经彩超引导下行双侧腰方肌阻滞（注射盐酸罗哌卡因），对照组单纯注射生理盐水，比较两组患者术后镇痛指标、视觉模拟评分（visual analogue score，VAS）、血清CD4+CD25+ T细胞水平及不良反应。结果 观察组的舒芬太尼用量、镇痛泵按压次数和补救性镇痛比例均低于对照组（P＜0.05），但镇痛满意度评分高于对照组（P＜0.05）；观察组术后2 h、6 h、12 h和24 h静息状态和运动状态的VAS评分均低于对照组（P＜0.05）；观察组手术前后CD4+CD25+ T细胞含量差值高于对照组（2.0±0.8 vs 1.1±0.6，t=5.248，P<0.001）；观察组麻醉后发生恶心呕吐比例（5.9% vs 26.5%）、眩晕比例（2.9% vs 20.6%）均低于对照组（P＜0.05）。结论 术前超声引导下单次腰方肌阻滞可减少胃癌根治术患者镇痛药物的使用量，提高术中和术后镇痛效果及术后疼痛满意度，且T细胞免疫功能恢复更快，不良反应较少，有利于早期康复。
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Effect of preoperative ultrasound-guided quadratus lumborum block on early recovery and T cell immune#br#
#br#
function in patients undergoing radical gastrectomy#br# |
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| ZHOU Bo,MAO Xiaoli,HU Lei.Effect of preoperative ultrasound-guided quadratus lumborum block on early recovery and T cell immune#br#
#br#
function in patients undergoing radical gastrectomy#br#[J].Chinese Journal of Oncology Prevention and Treatment,2019,11(4):318-322. |
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| Authors: | ZHOU Bo MAO Xiaoli HU Lei |
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| Abstract: | Objective To investigate the effect of preoperative ultrasound-guided quadratus lumborum block（QLB） on early recovery and T cell immune function in patients undergoing radical gastrectomy. Methods Ｔotals of 68 patients who underwent radical gastrectomy in our hospital were selected as the study subjects from March 2017 to June 2018，and divided into observation group（n=34） and control group（n=34） according to random number table method. After anesthesia induction，the observation group received color Doppler ultrasound-guided bilateral QLB（ropivacaine hydrochloride injection），while the control group received saline injection only. The postoperative analgesia indexes，VAS scores，serum CD4+CD25+ T cells level and adverse reactions of the two groups were compared. Results The dosage of sufentanil，the times of pressing analgesic pump and the proportion of remedial analgesia in the observation group were lower than the control group（P<0.05），and the score of analgesic satisfaction was higher than that in the control group（P<0.05）. The VAS scores of resting and moving state at 2，6，12 and 24 h after operation in the observation group were lower than those in the control group（P<0.05）. The difference of CD4+CD25+ T cells content before and after operation in the observation group was higher than that in the control group（2.0±0.8 vs 1.1±0.6，t=5.248，P＜0.001）. The proportion of nausea and vomiting（5.9% vs 26.5%），and vertigo（2.9% vs 20.6%）after anesthesia in the observation group were lower than those in the control group（P<0.05）. Conclusions Preoperative ultrasound-guided quadratus lumborum block can reduce the dosage of analgesic drugs in patients undergoing radical gastrectomy，improve the analgesic effect during and after operation，the satisfaction of pain after operation and T cell immune function and with less adverse reactions. |
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