椎旁神经阻滞复合全身麻醉对行腹腔镜远端胃癌根治术患者术后应激反应的影响

摘要

Objective To explore the effect of paravertebral nerve block anesthesia combined with general anesthesia on stress reaction in patients undergoing laparoscopic distal gastrectomy.Method From January 2015 to December 2016, 78 patients with laparoscopic distal gastrectomy admitted to the First People's Hospital of Yichang were selected as the research objects. According to the principle of complete random number table, all patients were randomly divided into control group and observation group with 39 cases in each group. Patients in both groups were given the general anesthesia, while observation group patients received paravertebral nerve block anesthesia as well. And the stress reaction of the two groups were observed.Result 3 days after operation, self-rating anxiety scale(SAS) scores, self-rating depression scale (SDS) scores, C reactive protein (CRP) and angiotensin Ⅱ (AngⅡ) levels of the two groups were significantly lower than those of before operation (P<0.05), and the levels of above indexes of observation group were significantly lower than those of control group (P<0.05). The anal exhaust time, hospital day, postoperative drainage time, volume of postoperative drainage and incidence of complication after operation had no significantly differences between the two groups (P>0.05).Conclusion Parave rtebral nerve block anesthesia combined with general anesthesia can reduce the postoperative stress reaction in patients with laparoscopic distal gastrectomy, it's worth of clinical promoting.%目的 探讨椎旁神经阻滞复合全身麻醉对行腹腔镜远端胃癌根治术患者术后应激反应的影响.方法 选择宜昌市第一人民医院2015年1月至2016年12月收治的行腹腔镜远端胃癌根治术患者78例为研究对象,将其按照完全随机数字表原则分为对照组和观察组,每组各39例.两组患者术前均给予全身麻醉,观察组在此基础上给予椎旁神经阻滞麻醉.观察两组患者术后应激反应的差异.结果 术后3天,两组患者焦虑自评量表(self-rating anxiety scale,SAS)评分、抑郁自评量表(self-rating depression scale,SDS)评分、C反应蛋白(C reaction protein,CRP)及血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)水平均显著低于术前(P<0.05),且观察组上述指标水平均显著低于对照组(P<0.05).两组患者术后首次肛门排气时间、术后住院天数、术后引流时间、术后引流量、术后并发症发生率比较均无显著差异(P>0.05).结论 椎旁神经阻滞复合全身麻醉有助于减轻腹腔镜远端胃癌根治术患者术后应激反应.