目的 分析腹横肌平面阻滞辅助全身麻醉在结直肠癌根治术中的应用效果.方法 选取收治的80例结直肠癌根治术患者,按随机数字表法分为两组,各40例.对照组行全身麻醉,观察组行腹横肌平面阻滞辅助全身麻醉.对比两组应激反应、免疫功能、不良反应.结果 麻醉前(T0),两组去甲肾上腺素(NE)、皮质醇(Cor)相比,无统计学差异(P＞0.05);插管时(T1)、术毕时(T2),观察组 NE 分别为(371.54±30.69)pmol/L、(342.59±28.41)pmol/L,Cor 分别为(225.84±20.36)nmol/L、(189.83±19.33)nmol/L,均低于对照组(426.72±32.45)pmol/L、(388.97±30.41)pmol/L、(271.57±23.67)nmol/L、(238.76±21.54)nmol/L,有统计学差异(P＜0.05);术前两组 CD3+、CD4+、CD8+相比,无统计学差异(P＞0.05);术后观察组 CD3+为(46.71±3.59)％、CD4+为(41.59±2.77)％,高于对照组的(40.83±3.01)％、(35.42±2.54)％,CD8+为(32.49±2.88)％,低于对照组的(36.71±3.46)％,有统计学差异(P＜0.05);两组不良反应比较,无统计学差异(P＞0.05).结论 腹横肌平面阻滞辅助全身麻醉在结直肠癌根治术中效果显著,能够控制应激反应,减轻免疫功能抑制,且无严重不良反应,临床应用价值较高.
The Application Effect of Abdominal Transverse Muscle Plane Block Assisted General Anesthesia in Radical Surgery for Colorectal Cancer
Objective To analyze the application effect of transverse abdominis plane block assisted general anesthesia in radical surgery for colorectal cancer.Methods 80 patients who underwent radical surgery for colorectal cancer were selected and randomly divided into 2 groups,each with 40 cases,using a random number table method.The control group received general anesthesia,while the observation group received plane block of the transverse abdominal muscle as an auxiliary general anesthe-sia.Compare the stress response,immune function,and adverse reactions between the 2 groups.Results Before anesthesia(T0),there was no statistically significant difference(P＞0.05)in the levels of norepinephrine(NE)and cortisol(Cor)between the 2 groups;At the time of intubation(T1)and the end of surgery(T2),the NE of the observation group was(371.54±30.69)pmol/L,(342.59±28.41)pmol/L,and the Cor was(225.84±20.36)nmol/L and(189.83±19.33)nmol/L,respectively,which were lower than the control group(426.72±32.45)pmol/L,(388.97±30.41)pmol/L,(271.57±23.67)nmol/L,and(238.76±21.54)nmol/L,with statistical differences(P＜0.05);There was no statistically significant difference in CD3+,CD4+,and CD8+between the 2 groups before surgery(P＞0.05);The postoperative observation group had(46.71±3.59)％CD3+and(41.59±2.77)％CD4+,which were higher than the control group(40.83±3.01)％and(35.42±2.54)％,and(32.49±2.88)％CD8+,which were lower than the control group(36.71±3.46)％,with statistical differences(P＜0.05);There was no statistically significant difference in adverse reactions between the 2 group(P＞0.05).Conclusion Abdominal transverse muscle plane block assisted general anesthesia has a significant effect in radical surgery for colorectal cancer,can con-trol stress response,alleviate immune suppression,and has no serious adverse reactions.Its clinical application value is high.
Radical resection of colorectal cancerAbdominal transverse muscle plane blockGeneral anesthesiaStress responseImmunologic function
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