论文部分内容阅读
目的:探讨全身麻醉联合超声引导下胸椎旁阻滞对食管癌手术患者生命体征及术后镇痛的影响;方法:将2016年1月至2017年2月惠东县人民医院收治的60例行食管癌手术患者随机分为两组各30例。对照组采用全身麻醉联合硬膜外麻醉,观察组采用全身麻醉联合超声引导下胸椎旁阻滞术。比较两组患者相关生命体征、视觉模拟评分法(VAS)评分及手术指标的差异;结果:两组患者T0、T3期平均动脉压(MAP)、心率(HR)水平比较,差异均无统计学意义(P>0.05);观察组患者T1、T2期MAP、HR水平降低,也显著低于同期对照组,差异具有统计学意义(P<0.05);对照组患者T1、T2期MAP、HR水平显著高于T0、T3期,差异具有统计学意义(P<0.05);观察组患者术后3 h、6 h、12 h、24 h VAS评分显著低于对照组,差异具有统计学意义(P<0.05);观察组患者手术耗时、手术出血量与对照组比较,差异均无统计学意义(P>0.05);观察组患者呼吸机通气时间显著低于对照组,差异具有统计学意义(P<0.05);结论:全身麻醉联合超声引导下胸椎旁阻滞对食管癌手术效果佳,术中可稳定患者生命体征,呼吸支持时间短,术后疼痛少。
Objective: To investigate the effect of general anesthesia combined with ultrasound-guided thoracic paravertebral block on vital signs and postoperative analgesia of patients undergoing esophageal cancer surgery.Methods: 60 patients who were treated in Huidong County People’s Hospital from January 2016 to February 2017 Esophageal cancer patients were randomly divided into two groups of 30 cases. The control group was treated with general anesthesia combined with epidural anesthesia. The observation group was under general anesthesia combined with ultrasound-guided thoracic paravertebral block. The VAS scores and operative indexes were compared between the two groups. Results: There were no significant differences in mean arterial pressure (MAP) and heart rate (HR) between the two groups at T0 and T3 (P <0.05). The levels of MAP and HR in T1 and T2 of the observation group were significantly lower than those in the control group (P <0.05). The levels of MAP and HR in T1 and T2 of the control group were significantly lower than those in the control group (P <0.05). The VAS scores in observation group at 3 h, 6 h, 12 h and 24 h after operation were significantly lower than those in control group (P <0.05), and the difference was statistically significant (P <0.05) <0.05). There was no significant difference between the observation group and the control group (P> 0.05). The ventilator ventilation time in the observation group was significantly lower than that in the control group (the difference was statistically significant (P < P <0.05). CONCLUSION: Thoracic paravertebral block under the guidance of general anesthesia combined with ultrasound is effective in esophageal cancer surgery. It can stabilize the vital signs of patients during operation and has shorter respiratory support time and less postoperative pain.