[1]刘文胜,朱丽,王润.超声引导下胸椎旁神经阻滞联合全身麻醉对胸腔镜下肺癌根治术患者术中应激指标及术后疼痛水平的影响[J].陕西医学杂志,2026,(4):491-495.[doi:DOI:10.3969/j.issn.1000-7377.2026.04.010]
　LIU Wensheng,ZHU Li,WANG Run.Effects of ultrasoundguided TPVB combined with general anesthesia on intraoperative stress indexes and postoperative pain levels in patients undergoing Thoracoscopic radical resection of lung cancer[J].,2026,(4):491-495.[doi:DOI:10.3969/j.issn.1000-7377.2026.04.010]
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超声引导下胸椎旁神经阻滞联合全身麻醉对胸腔镜下肺癌根治术患者术中应激指标及术后疼痛水平的影响

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2026年4期
页码:
491-495
栏目:
临床研究
出版日期:
2026-04-05

文章信息/Info

Title:
Effects of ultrasoundguided TPVB combined with general anesthesia on intraoperative stress indexes and postoperative pain levels in patients undergoing Thoracoscopic radical resection of lung cancer
作者:
刘文胜; 朱丽; 王润
（四川省人民医院金牛医院麻醉科，四川 成都 610007）
Author(s):
LIU Wensheng; ZHU Li; WANG Run
（Department of Anesthesiology,Jinniu District People’s Hospital,Chengdu 610007，China）
关键词:
胸腔镜下肺癌根治术; 超声引导下胸椎旁神经阻滞; 全身麻醉; 应激反应; 疼痛; 安全性
Keywords:
Thoracoscopic radical resection of lung cancer; TPVB; General anesthesia; Stress response; Pain; Safety
分类号:
R 743.2
DOI:
DOI:10.3969/j.issn.1000-7377.2026.04.010
文献标志码:
A
摘要:
目的：从术中应激与术后疼痛角度观察超声引导下胸椎旁神经阻滞（TPVB）联合全身麻醉用于胸腔镜下肺癌根治术患者的效果。方法：前瞻性选取胸腔镜下肺癌根治术患者140例，随机分为研究组（超声引导下TPVB联合全身麻醉）与对照组（全身麻醉），均为70例。比较应激指标[去甲肾上腺素（NE）、前列腺素（PGE2）]、疼痛、麻醉效能、不良反应及康复效果[中文版康复质量量表（QoR）]。结果：NE、PGE2、视觉模拟评分（VAS）随着时间变化的趋势而有统计学差异（P时点＜0.05），时间与组别之间有交互作用（P交互＜0.05）；两组患者拔管10 min（T4）NE、PGE2均高于麻醉诱导前（T0）（均P＜0.05），研究组麻醉诱导后（T1）、气管插管时（T2）、拔管时（T3）、T4 NE、PGE2均低于对照组（均P＜0.05）；两组患者术后2 h（t1）、术后4 h（t2）、术后12 h（t3）术后24 h（t4）时点VAS评分均低于术毕5 min（t0）（均P＜0.05），研究组t1、t2、t3、t4时点VAS评分均低于对照组（均P＜0.05）。研究组阿片类药物用量[（725.27±110.19 与 875.26±123.59）mg]及镇痛泵按压次数[（4.23±1.99 与 7.34±2.29）次]均低于对照组（均P＜0.05）。研究组总发生率8.57%，低于对照组的24.29%（P＜0.05）。研究组术后3 d QoR评分（87.24±19.95 与 75.97±19.14）高于对照组（P＜0.05）。结论：超声引导下TPVB联合全身麻醉应用于胸腔镜下肺癌根治术中具有良好效果，能降低术中应激指标及术后疼痛，并促进患者康复。
Abstract:
Objective:Observe the effect of ultrasound guided TPVB combined with general anesthesia on intraoperative stress indicators and postoperative pain levels in patients undergoing thoracoscopic radical resection of lung cancer.Methods：140 patients who underwent thoracoscopic radical resection of lung cancer in Sichuan Provincial People’s Hospital Jinniu Hospital from May 2021 to May 2022 were prospectively selected and randomly divided into a study group （ultrasoundguided TPVB combined with general anesthesia） and a control group （general anesthesia）,with 70 cases in each group.Stress indexes （norepinephrine （NE）,prostaglandin （PGE2）,pain,anesthetic efficacy,adverse reactions and rehabilitation effect [Chinese version of Rehabilitation Quality Scale （QoR）]were compared.Results:The scores of NE,PGE2 and Visual Analogue Scale（VAS）changed with time （P time point<0.05）,and there was an interaction between time and group （P interaction<0.05）.NE and PGE2 at T4 were higher than T0 in 2 groups （all P<0.05）,and NE and PGE2 at T1,T3 and T4 in study group were lower than those in control group （all P<0.05）.The VAS scores at t1,t2,t3 and t4 in both groups were lower than t0 （all P<0.05）,and the VAS scores at t1,t2,t3 and t4 in the study group were lower than those in the control group （all P<0.05）.The dosage of opioids in the study group [（725.27±110.19 vs 875.26±123.59） mg]and the pressing times of analgesic pump [（4.23±1.99 vs 7.34±2.29） times]were lower than those in the control group （all P<0.05）.The total incidence in the study group was 8.57%,which was lower than that in the control group 24.29%（ all P<0.05）.The postoperative 3 d QoR score of the two groups was higher than that of the postoperative 1 d （P<0.05）,and the postoperative 3d QoR score of the study group was higher than that of the control group （P<0.05）.Conclusion:Ultrasoundguided TPVB combined with general anesthesia has a good effect in the thoracoscopic radical resection of lung cancer,which can reduce the intraoperative stress index and postoperative pain,and promote the recovery of patients.

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备注/Memo

备注/Memo:
中国红十字基金会医学赋能公益专项基金资助项目(CRCFYXFN202302160)
更新日期/Last Update: 2026-04-05