| 薛 磊,贾洪峰,江婷婷,韩 昱,张 娟.超声引导下不同TPV对单孔胸腔镜肺癌根治术患者MCP-1、PGE2等指标的影响[J].,2020,(11):2156-2159 |
| 超声引导下不同TPV对单孔胸腔镜肺癌根治术患者MCP-1、PGE2等指标的影响 |
| The Effects of Different TPBV on McP-1, PGE2 and Other Indicators in Patients Undergoing Single-port Thoracoscopic Radical Resection of Lung Cancer Under Ultrasound Guidance |
| 投稿时间：2020-01-23 修订日期：2020-02-18 |
| DOI：10.13241/j.cnki.pmb.2020.11.034 |
| 中文关键词: 超声引导 TPBV 单孔胸腔镜肺癌根治术 肺功能 |
| 英文关键词: Ultrasonic guidance TPBV Single-orifice thoracoscopic radical resection of lung cancer Lung function |
| 基金项目:国家自然科学基金项目（81302153） |
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| 中文摘要: |
| 摘要 目的：探讨超声引导下不同胸椎旁神经阻滞(thoracic paravertebral nerve block, TPVB)对单孔胸腔镜肺癌根治术患者巨噬细胞趋化蛋白-1 (monocyte chemotactic protein-1，MCP-1)、 血浆前列腺素E-2（prostaglandin E-2，PGE 2）等指标的影响。方法：选择我院2016年1月至2019年12月收治的96例择期行单孔胸腔镜的肺癌根治术患者，A组采用全身麻醉+自控静脉镇痛法，B组采用全麻+单次TPVB+自控静脉镇痛方法，C组采用全麻+连续TPVB麻醉法，对比三组的不同时间点的动脉血氧分压(partial arterial oxygen pressure，PaO2)、动脉二氧化碳分压(arterial carbon dioxide partial pressure，PaCO2)、肺泡动脉血氧分压差(difference of alveolar arterial oxygen partial pressure，PA-aO2)、1秒用力呼气容量(1 second forced expiratory volume，FEV1)、用力肺活量(forced vital capacity，FVC)、最大呼气中段流量(maximum expiratory flow，MMF)等。结果：T3及T4点时，三组的PaO2、FEV1、FVC、MMF较T0点明显降低，三组以上指标水平为A组A-aO2较T0点明显升高，为A组>B组>C组（P<0.05）。三组的MCP-1、PGE2及TNF-α水平在T0点时对比无差异（P>0.05），T3、T4点时，三组以上指标明显上升，A组>B组>C组（P<0.05）。结论：全麻联合TPVB超声引导下连续TPBV法可改善患者的肺功能，促进肺部氧合，可能与其可对患者炎性指标影响较小有关。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of different TPBV on MCP-1, PGE2 and other indicators in patients undergoing single-port thoracoscopic radical resection of lung cancer under ultrasound guidance. Methods: 96 cases admitted to our hospital from January 2016 to December 2019 who underwent elective single-orifice thoracoscopic radical resection of lung cancer were selected, group A were given general anesthesia+controlled intravenous analgesia, group B were given general anesthesia+ single TPVB+controlled intravenous analgesia, group C were given general anesthesia + continuous TPVB. The levels of PaO2, PaCO2, PA-aO2, FEV1, FVC, MMF. Results: At T3 and T4, the PaO2, FEV1, FVC and MMF in three groups were significantly lower than that of T0, and the index levels of three groups were group AA-aO2 was significantly higher than T0, group A>group B>group C(P<0.05). The levels of MCP-1, PGE2, and TNF-α in the three groups were not statistically significant at the T0 point (P>0.05). At the T3,T4 points, the above three indicators were more than T0 The points increased significantly, and the comparison of the three groups was statistically significant at the same time point of T3,T4, group A>group B> group C (P<0.05). Conclusion: General anesthesia combined with TPVB ultrasound-guided continuous TPBV can improve patients 'lung function and promote lung oxygenation, which may be related to their less impact on patients' stress and inflammatory indexes. |
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