超前镇痛对自主呼吸下行胸腔镜肺叶切除术患者术后的镇痛效果
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河北省沧州市重点研发计划指导项目(213106146);


Analgesia effect of preemptive analgesia on patients after thoracoscopic lo-bectomy under spontaneous breathing
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    摘要:

    目的:探讨超前镇痛对自主呼吸下行胸腔镜肺叶切除术患者术后的镇痛效果。方法:选取116例行胸腔镜肺叶切除术患者为研究对象,根据麻醉干预方式不同分为对照组和研究组,每组各58例。对照组患者实施自主呼吸下的胸椎旁神经阻滞麻醉;研究组患者实施盐酸纳布啡超前镇痛联合自主呼吸下的胸椎旁神经阻滞麻醉。比较两组患者血流动力学指标[心率(HR)、平均动脉压(MAP)、血氧饱和度(SPO2)]、术后镇痛镇静效果[视觉模拟评分法(VAS)评分、Ramsay镇静评分]、疼痛因子[前列腺素E2(PGE2)、P物质(SP)、多巴胺(DA)]水平、炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、C反应蛋白(CRP)]水平及不良反应发生情况。结果:麻醉前,两组患者HR、MAP、SPO2比较,差异无统计学意义(P>0.05);麻醉后,研究组患者HR、MAP低于对照组(P<0.05),SPO2高于对照组(P<0.05)。术后,研究组患者VAS评分、Ramsay评分及PGE2、SP、DA、TNF-α、IL-6、CRP水平低于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:使用盐酸纳布啡进行超前镇痛能提高胸腔镜肺叶切除术患者镇痛效果,稳定血流动力学指标,减轻术后疼痛及炎性反应。

    Abstract:

    Objective:To explore the analgesia effect of preemptive analgesia on patients after thoracoscopic lobectomy under spontaneous breathing.Methods:116 patients who received thoracoscopic lobectomy were included as the study subjects.According to the intervention methods,58 patients who received thoracic paravertebral nerve block under spontaneous breathing were randomly col-lected as control group,and 58 patients who adopted preemptive analgesia combined with thoracic paravertebral nerve block under spon-taneous breathing were included in study group.The intraoperative vital signs[heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation(SPO2)],analgesia and sedation effects[visual analogue scale(VAS)score,Ramsay sedation score],pain factors[prostaglandin E2(PGE2),substance P(SP),dopamine(DA)]and inflammatory factors[tumor necrosis factor-α(TNF-α),inter-leukin-6(IL-6),C-reactive protein(CRP)]after surgery and incidence rates of adverse reactions were compared between the two groups.Results:There were no statistical differences in HR,MAP,and SPO2 before anesthesia between groups(P>0.05).After anes-thesia,HR and MAP in study group were lower than those in control group(P<0.05)while SPO2 was higher than that in control group(P<0.05).After surgery,the VAS score,Ramsay score,and levels of PGE2,SP,DA,TNF-α,IL-6,and CRP in study group were lower than those in control group(P<0.05).There were no statistical differences in the incidence rates of adverse reactions between groups(P>0.05).Conclusion:For patients undergoing thoracoscopic lobectomy,the application of nalbuphine hydrochloride for preemptive analgesia can enhance the analgesia effect,stabilize hemodynamic indicators,and alleviate postoperative pain and inflammatory reac-tions.

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吴水水;孙宗建;牛志强;.超前镇痛对自主呼吸下行胸腔镜肺叶切除术患者术后的镇痛效果[J].川北医学院学报,2025,40(2):233-236.

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  • 在线发布日期: 2025-07-24
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