胸横肌平面阻滞对体外循环下心脏瓣膜置换术的应用研究
Study on the Application of Thoracic Transverse Muscle Planar Block in Cardiovascular Valve Replacement under Extracorporeal Circulation
史梦圆 1肖洒2
作者信息
- 1. 郑州市第七人民医院 麻醉科,河南 郑州 450000
- 2. 郑州大学第二附属医院肿瘤科,河南郑州45000
- 折叠
摘要
目的 观察胸横肌平面阻滞(TTP)对体外循环(CPB)下心脏瓣膜置换术的应用效果.方法 本研究为前瞻性研究,选择的研究对象为2021年6月～2023年9月期间至郑州市第七人民医院接受CPB心脏瓣膜置换术治疗的98例患者,以计算机随机分组法将其分为常规组(49例)和TTP组(49例),常规组实施常规全身麻醉,TTP组采用TTP辅助麻醉,比较两组患者围手术期基础体征,术前术后应激指标变化情况,术后6h、12h等时间点下静息或咳嗽时的疼痛情况,及术后并发症发生情况.结果 TTP组切皮时(T1)的心率(HR)、平均动脉压(MAP)均低于常规组;锯胸骨时(T2)的HR、MAP、血管紧张素Ⅱ(Ang Ⅱ)、β-内啡肽(β-EP),术后6h、12h静息时的视觉模拟疼痛量表(VAS)评分、咳嗽时的VAS评分均低于常规组,差异均具有统计学意义(P＜0.05).试验组的术后并发症发生率略高于常规组,差异无统计学意义(P＞0.05).结论 TTP联合全身麻醉能稳定CBP下心脏瓣膜置换术患者的基础体征,并减轻应激损伤,对缓解患者术后疼痛并降低并发症发生风险均有积极意义.
Abstract
Objective the application effect of TTP on cardiac valve replacement surgery under CPB.Methods:This study is a prospective study.98 patients who underwent CPB heart valve re-placement surgery at our hospital from June 2021 to September 2023 were selected as the study subjects.They were randomly divided into a conventional group(49 cases)and a TTP group(49 cases)using computer randomization.The conventional group received routine general anesthe-sia,while the TTP group received TTP assisted anesthesia.The basic signs,changes in stress indicators before and after surgery,and postoperative 6 hours were compared between the two groups Pain during rest or coughing at a time point of 12 hours,as well as postoperative compli-cations.Results HR and MAP during TTP group skin cutting(T1)and sternal sawing(T2),as well as Ang Ⅱ β-EP,VAS scores at rest at 6 and 12 hours postoperatively,and VAS scores dur-ing coughing were lower than those in the control group(P＜0.05).The incidence of postopera-tive complications in the experimental group was slightly higher than that in the control group(P＞0.05).Conclusion The combination of TTP and general anesthesia can stabilize the basic physical signs of patients undergoing heart valve replacement surgery under CBP,reduce stress damage,and have positive significance in alleviating postoperative pain and reducing the risk of complications.
关键词
体外循环/心脏瓣膜置换术/胸横肌平面阻滞/应激损伤/术后并发症Key words
Extracorporeal circulation/Heart valve replacement surgery/Thoracic transverse muscle plane block/Stress damage/Postoperative complications引用本文复制引用
基金项目
河南省医学科技攻关计划(LHGJ20210012216)
出版年
2024
NETL
NSTL
维普
万方数据