| 胡晓可,滕金亮,田龙.星状神经节阻滞在老年肺癌患者电视辅助胸腔镜手术中的应用价值[J].老年医学与保健,2026,32(2):276-283 |
| 星状神经节阻滞在老年肺癌患者电视辅助胸腔镜手术中的应用价值 |
| Application value of stellate ganglion block in video-assisted thoracoscopic surgery for elderly patients with lung cancer |
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| DOI：10.3969/j.issn.1008-8296.2026.02.022 |
| 中文关键词: 老年 肺癌 电视辅助胸腔镜手术 星状神经节阻滞 应用价值 |
| 英文关键词: elderly lung neoplasms video-assisted thoracoscopic surgery stellate ganglion block application value |
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| 中文摘要: |
| 目的 探讨星状神经节阻滞(SGB)在老年肺癌患者电视辅助胸腔镜手术(VATS)中的应用价值.方法 选取2022 年9 月至2024 年9 月河北北方学院附属第一医院接受 VATS 的84 例老年肺癌患者进行前瞻性研究.根据随机数字表法将患者随机分为试验组(n=42)和对照组(n=42),对照组术中采用改良肋间神经阻滞(MINB),试验组采用MINB 联合 SGB.比较2 组患者的血流动力学指标、围手术期阿片类药物使用量、术后疼痛管理相关指标、术后72 h 内切口和胸腔在静息及活动状态下的疼痛视觉模拟量表(VAS)评分.结果 试验组和对照组的平均动脉压和心率差异均有统计学意义(均 P<0.05),试验组3 个时间点的平均动脉压和4 个时间点的心率均低于对照组(均 P<0.05).试验组瑞芬太尼累积量少于对照组(P<0.05),术后24 h 胸腔活动VAS 评分、胸痛持续至少24 h 的患者比例和自控镇痛泵综合使用率均低于对照组(均 P<0.05).2 组切口静息和活动 VAS 评分时间效应有统计学意义(F=89.96、46.13,均 P<0.05);2 组胸腔静息 VAS 评分时间效应有统计学意义(F=15.98,P<0.05),术后12、24 h 时试验组胸腔静息 VAS 评分低于对照组(均 P<0.05);2 组胸腔活动 VAS 评分时间效应和组别效应均有统计学意义(F=24.23、29.83,均 P<0.05),术后3、6、12、24、48 h 时试验组胸腔活动VAS 评分低于对照组(均P<0.05).结论 SGB 可一定程度降低老年肺癌患者VATS 围手术期阿片类药物使用量,减轻术后疼痛,具有一定的临床应用价值. |
| 英文摘要: |
| Objective To explore the application value of stellate ganglion block(SGB)in video-assisted thoracoscopic surgery(VATS)for elderly patients with lung cancer.Methods A prospective study was conducted on84 elderly lung cancer patients who underwent VATS in First Affiliated Hospital of Hebei North University from September 2022 to September 2024.The patients were randomly divided into experimental group(n=42)and control group(n=42)based on a digital table.The control group received modified intercostal nerve block(MINB),while the experimental group received MINB combined with SGB.The hemodynamic parameters,perioperative opioid consumption,postoperative pain managementrelated indicators,and visual analogue scale(VAS)scores for pain in the incision and thoracic cavity at rest and during activity within 72 h after surgery were compared between the two groups.Results There were statistically significant differences in mean arterial pressure(MAP)and heart rate(HR)between the two groups(all P<0.05).MAP at three time points and HR at four time points in the experimental group were lower than those in the control group(all P<0.05).The cumulative consumption of remifentanil in the experimental group was less than that in the control group(P<0.05).The postoperative 24 h VAS score for chest pain during activity,the proportion of patients with chest pain lasting at least 24 h,and the comprehensive utilization rate of patient-controlled analgesia pumps in the experimental group were all lower than those in the control group(all P<0.05).There was a statistically significant difference in the time effect of the VAS scores for incision pain at rest and during activity between the two groups(F=89.96,46.13;both P<0.05).There was a statistically significant difference in the time effect of the VAS scores for chest pain at rest between the two groups(F=15.98,P<0.05).The VAS scores for chest pain at rest in the experimental group were lower than those in the control group at12 h and24 h after surgery(both P<0.05).There were statistically significant differences in both time effect and group effect of the VAS scores for chest pain during activity between the two groups(F=24.23,29.83,both P<0.05).At 3,6,12,24,and 48 h after surgery,the VAS scores for chest pain during activity in the experimental group were lower than those in the control group(all P<0.05).Conclusion SGB can reduce perioperative opioid consumption and postoperative pain to some extent in elderly lung cancer patients undergoing VATS.It has certain clinical application value. |
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