单侧胸椎旁阻滞复合全麻对老年食管癌患者苏醒期躁动及认知功能的影响.docx

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1、单侧胸椎旁阻滞复合全麻对老年食管癌患者苏醒期躁动及认知功能的影响程蕾涂小磊表1两组血流动力学变化情况比较（xs）组别MAPmm Hg%T,t2Lt4对照组（n=39 ）8L186.8788.39 6.58*80.36 8.3 T91.63*9.27*81.69 9.56观察组（=39 ）81.16 6.9287.98 7.03*75.03 8.02*84.12 8.23#76.11 7.76，值0.0130.2662.8823.7832.830值0.9900.791O.(X)5O.(XM)O.(X)6表1（续）组别HK次 /minTor.t4对照组（=39）71.22 43676.21 5.7

2、4*73.11 3.45*85.13 5.24#74.68 437*观察组（=39）71.23 4.4175.42 5.2/73.06 4.5/80.11 5.15*68.13 3.07*，值0.0100.6331.2364.2677.659。值0.9920.5290.2200.0000.00()与 T。比较.P0. 05) ；T0、Tk T2,两组HR比较，差异均无统计学意义(P0. 05) o Tl、T2、T3,两组MAP与TO时比较，差昊均有统计学意义(P0. 05) ；T1, T2、T3、T4,两组HR与TO比较，差异均有统计学意义(P0. 05) o观察组T2、T3、T4的MAP均低

3、于对照组，T3、T4的HR均低于对照组，差异均有统计学意义(P0.05) o观察组气管拔管时间短于对照组，拔管前躁动评分、拔管后10 min VAS评分均低于对照组，差异均有统计学意义(P0. 05) 0术后7 d,对照组MMSE评分低于术前1 d,差异有统计学意义(P0.05) o术后7 d,两组MMSE评分比较，差异有统计学意义(P0. 05) . At TO, T1 and T2, there wereno significant differences in HR between two groups (P0. 05) . AtTl, T2 and T3, there were sta

4、tistically significant differences inMAP of two groups compared with TO (P0. 05) ； at Tl, T2, T3 andT4, there were statistically significant differences in HR of twogroups compared with TO (P0. 05) . At T2, T3 and T4, MAP ofobservation group were 1ower than those of control group, at T3 andT4, the H

5、R of observation group were lower than those of controlgroup, the differences were statistically significant (P0. 05).The time of tracheal extubation of observation group was shorter thanthat of control group, and the agitation score before extubation andVAS score 10 min after extubation were 1ower

6、than those of controlgroup, the differences were significant differences (P0. 05) . At 7 d after operation, the MMSEscore in the control group was lower than that 1 d before operation,the difference was statistically significant (P0.05) . At 7 d afteroperation, there was statistical difference in MM

7、SE scores betweenthe two groups (P0. 05) . Conclusion： The application of unilateralthoracic paravertebral block combined with general anesthesia inelderly patients with esophageal cancer has little effect onhemodynamics, it has certain advantages in reducing emergenceagitation, relieving pain and i

8、mproving cognitive function in therecovery period of patients, which is conducive to postoperativerecovery of patients.Key words Esophageal cancer Unilateral thoracic paravertebral blockGeneral anesthesia Hemodynamics Emergence agitation CognitivefunctionFirst-authors address： Xiaogan Central Hospital, Xiaogan 432000,Chinadoi： 10. 3969/j. issn. 1674-4985. 2021. 20. 039食管癌是陶床上常见的恶性肿瘤，以进行性吞咽困难为典型症状，我国每年约有15万人死于此病1。目前，食管癌发病机制尚不明确，多认为与饮食、环境、遗传等因素有关。食管癌根治术是目前治疗该病的首选方法，但该术式对患者创伤较大，会引起患者较强的应激反应，影响手术效果，不利于预后2-3。全麻是食管癌根治术中常用的麻醉方式，但在苏醒期患者常出