| 朱云霞,尤 杰,孙大鹏,王海浪,季 永.右美托咪定复合腰方肌阻滞对腹腔镜胃癌根治术患者术后镇痛效果、应激反应和Thl/Th2平衡的影响[J].,2021,(23):4573-4577 |
| 右美托咪定复合腰方肌阻滞对腹腔镜胃癌根治术患者术后镇痛效果、应激反应和Thl/Th2平衡的影响 |
| Effects of Dexmedetomidine Combined with Psoas Quadratus Muscle Block on Postoperative Analgesia, Stress Response and Thl/Th2 Balance in Patients Undergoing Laparoscopic Radical Gastrectomy for Gastric Cancer |
| 投稿时间：2021-04-27 修订日期：2021-05-23 |
| DOI：10.13241/j.cnki.pmb.2021.23.037 |
| 中文关键词: 右美托咪定 腰方肌阻滞 腹腔镜胃癌根治术 术后镇痛 应激反应 Thl/Th2平衡 |
| 英文关键词: Dexmedetomidine Psoas quadratus muscle block Laparoscopic radical gastrectomy for gastric cancer Postoperative analgesia Stress response Thl/Th2 balance |
| 基金项目:江苏省科技厅社会发展项目（BE2018669） |
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| 中文摘要: |
| 摘要 目的：探讨右美托咪定复合腰方肌阻滞（QLB）对腹腔镜胃癌根治术患者术后镇痛效果、应激反应和Thl/Th2平衡的影响。方法：收集我院2019年1月~2021年5月接收的腹腔镜胃癌根治术患者80例。根据随机数字表法分为对照组和联合组，例数各为40例，对照组接受QLB，联合组接受右美托咪定复合QLB。对比两组视觉模拟评分法（VAS）评分。记录两组镇痛急救次数、镇痛泵有效按压次数。对比两组应激反应和Thl/Th2平衡。观察两组不良反应发生情况。结果：术后12 h、术后24 h、术后48 h联合组的VAS评分均低于对照组（P<0.05）。联合组的镇痛急救次数、镇痛泵有效按压次数少于对照组（P<0.05）。术后1 d，两组皮质醇（Cor）、肾上腺素（E）、促肾上腺皮质激素（ACTH）均较术前升高，但联合组低于对照组（P<0.05）。术后1 d，两组干扰素-γ（IFN-γ）、IFN-γ/白细胞介素-4（IL-4）较术前升高，且联合组高于对照组，IL-4较术前降低，且联合组低于对照组（P<0.05）。两组不良反应总发生率对比，无显著性差异（P>0.05）。结论：右美托咪定复合QLB可有效改善腹腔镜胃癌根治术患者术后疼痛情况，减轻应激反应，并改善术后免疫抑制状态，安全可靠。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of dexmedetomidine combined with psoas quadratus muscle block (QLB) on postoperative analgesia, stress response and Th1/Th2 balance in patients undergoing laparoscopic radical gastrectomy for gastric cancer. Methods: 80 patients with laparoscopic radical gastrectomy for gastric cancer who were received in our hospital from January 2019 to May 2021 were collected. According to the random number table method, they were divided into control group and combined group, the number of cases was 40. The control group received QLB, and the combined group received dexmedetomidine combined QLB. Visual analogue scale (VAS) scores were compared between the two groups. The first aid times of analgesia and the effective pressing times of analgesia pump were recorded in both groups. Stress response and Thl/Th2 balance were compared between the two groups. The occurrence of adverse reactions in two groups was observed. Results: VAS scores of the combined group were lower than those of the control group at 12 h, 24 h and 48 h after operation (P<0.05). The first aid times of analgesia and the effective pressing times of analgesia pump of the combined group were less than those of the control group (P<0.05). 1 d after operation, cortisol (Cor), epinephrine (E) and adrenocorticotropic hormone (ACTH) in the two groups were higher than those before operation, but the combined group was lower than the control group (P<0.05). 1 d after operation, interferon-γ (IFN-γ) and IFN-γ/interleukin-4 (IL-4) in the two groups were higher than before operation, and the combined group was higher than the control group. IL-4 was lower than before operation, and the combined group was lower than the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Dexmedetomidine combined with QLB can effectively improve the pain in patients undergoing laparoscopic radical gastrectomy for gastric cancer, reduce stress response and improve postoperative immunosuppression, which is safe and reliable. |
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