术前应用硫酸镁联合腰方肌局部阻滞对行全麻疝手术病人的疗效及对术后认知功能的影响分析

doi:10.3969/j.issn.1005-6483.2020.07.027

摘要/Abstract

摘要： 目的探讨术前应用硫酸镁联合腰方肌局部阻滞对行全麻疝手术病人的疗效及对术后认知功能的影响。
方法腹腔镜下腹股沟疝修补术病人80例，分为研究组和对照组，每组40例。研究组在全麻治疗基础上联合硫酸镁镇静联合腰方肌局部阻滞，对照组采用常规全麻，比较两组病人的临床疗效及可反映认知功能的指标Tau蛋白和Aβ42蛋白等差异。
结果术后研究组病人的镇痛满意度（90.0%）高于对照组（72.5%），差异有统计学意义（P＜0.05）；研究组T1的FLACC评分、PAED评分和T2的FLACC评分、PAED评分分别为（3.7±1.2）分、（3.5±0.5）分、（3.3±1.5）分和（2.7±0.8）分，对照组分别为（2.4±1.5）分、（2.3±0.8）分、（2.0±1.0）分和（1.7±0.5）分，两组比较差异有统计学意义（P＜0.05）；术后1周研究组病人的Tau蛋白和Aβ42蛋白分别为（46.3±12.0）ng/L和（93.6±20.1）ng/L，对照组分别为（55.2±18.10）ng/L和（86.1±18.5）ng/L，两组比较差异有统计学意义（P＜0.05）；麻醉后研究组病人心率为（95.8±7.5）次/分，血压为（106.6±8.3）mmHg，对照组分别为（106.8±8.5）次/分，血压（115.3±11.5） mmHg，两组比较差异有统计学意义（P＜0.05）。
结论术前应用硫酸镁联合腰方肌局部阻滞对行全麻疝手术病人的镇痛效果更佳，可改善病人术后认知功能，并有利于维持机体血流动力学的稳定性。

关键词: 硫酸镁, 腰方肌局部阻滞, 疗效, 血清指标, 术后认知障碍

Abstract: Objective To investigate the effect of preoperative application of magnesium sulfate combined with quadratus lumborum block（QLB）on patients undergoing general anesthesia and its influence on postoperative cognitive function.
Methods 80 patients who underwent laparoscopic inguinal hernia surgery were selected and divided into study group and control group，40 cases in each group.Patients in study group were given routine general anesthesia plus magnesium sulfate combined with quadratus lumborum block，and patients in control group were given routine general anesthesia，then the two groups were compared the differences in terms of clinical efficacy，Tau protein and Aβ42 protein.
Results The analgesia satisfaction of the study group（90.0%）were better than the control group（72.5%）after operation（P<0.05）.The FLACC score（3.7±1.2）and PAED score（3.5±0.5）of T1，the FLACC score（3.3±1.5）and PAED score（2.7±0.8）of T2 in the study group were significantly improved than the control group，which were（2.4±1.5），（2.3±0.8），（2.0±1.0）and （1.7±0.5），respectively（P<0.05）.One week after surgery，the Tau protein and Aβ42 protein of study group were（46.3±12.0）ng/L and（93.6±20.1）ng/L，respectively，which were significantly improved compared with the control group[（55.2±18.1）ng/L and（86.1±18.5）ng/L]，respectively（P<0.05）.After anesthesia，the heart rate[（95.8±7.5）beats / min] and blood pressure[（106.6 ± 8.3）mmHg] of the study group were better than those of the control group，which were（106.8±8.5）beats/min and （115.3±11.5）mmHg，respectively（P<0.05）.
Conclusion Preoperative application of magnesium sulfate combined with QLB has better analgesic effect on patients undergoing laparoscopic inguinal hernia surgery is significant，And it can improve patients' postoperative cognitive function and help maintain the hemodynamic stability of the body.

Key words: magnesium sulfate, quadratus lumborum block, clinical efficacy, serum indexes, postoperative cognitive impairment

李潞赵欣吴丽王仿张少波杨晓红. 术前应用硫酸镁联合腰方肌局部阻滞对行全麻疝手术病人的疗效及对术后认知功能的影响分析[J]. 临床外科杂志, 2020, 28(7): 687-689.

LI Lu, ZHAO Xin, WU Li, et al.. Analysis of the effect of preoperative application of magnesium sulfate combined with local lumbar square muscle block on patients undergoing general anesthesia and its influence on postoperative cognitive function[J]. JOURNAL OF CLINICAL SURGERY, 2020, 28(7): 687-689.

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