目的 分析超声引导下腹横肌平面阻滞复合环泊酚持续输注对胃癌根治术后患者炎症因子、TAU-181的影响。方法 选取2022-10至2024-10于武警江西总队医院进行胃癌根治术的患者84例,分为对照组和联合组,各42例。对照组给予超声引导下腹横肌平面阻滞（TAPB）,联合组给予超声引导下TAPB复合环泊酚。记录两组术后相关指标水平情况,评估不同时间点镇静及疼痛评分水平情况、简易智力状态检查量表（MMSE）评分水平情况,检测肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、C反应蛋白（CRP）、人磷酸化TAU-181蛋白（TAU-181）表达水平情况,记录两组不良反应情况。结果 联合组手术时间（138.15±20.27）min,短于对照组的（185.56±26.64）min,术中出血量（109.44±11.40）ml,少于对照组的（153.13±15.95）ml,术后首次使用镇痛药物时间（30.22±7.55）min,晚于对照组的（26.21±7.42）min,差异均有统计学意义（P<0.05）。术后6、12、48 h,联合组Ramsay镇静评分高于对照组,VAS评分低于对照组,差异均有统计学意义（P<0.05）;T1、T2、T3、T4时点,联合组MMSE评分高于对照组,差异均有统计学意义（P<0.05）;术后7d,联合组TNF-α、IL-6、CRP、TAU-181蛋白水平均低于对照组,差异均有统计学意义（P<0.05）。结论 对胃癌根治术后患者给予超声引导下TAPB复合环泊酚,能提高镇静程度,降低疼痛程度,改善认知功能,减轻炎症反应,调节TAU-181蛋白表达,降低术后并发症发生率,更利于术后恢复。
Abstract
Objective To analyze the effects of ultrasound-guided transverse abdominis plane block（TAPB）combined with continuous infusion of cyclopofol on inflammatory factors and TAU-181 in patients after radical gastrectomy for gastric cancer(GC). Methods A total of 84 patients who underwent radical gastrectomy for GC in Jiangxi Provincial Corps Hospital of Chinese People's Armed Police Force from October 2022 to October 2024 were selected and divided into a control group and a combination group,with 42 cases in each group. The control group was given ultrasound-guided TAPB, while the combined group received ultrasound-guided TAPB combined with cyclopofol. The level of postoperative indicators was recorded,the sedation and pain scores at different time points,the MMSE scale,the expression levels of TNF- α , IL-6,CRP,and TAU-181 were detected,and the adverse reactions of both groups were re- corded. Results The operation time of the combined group (138.15±20.27 min) was shorter than that of the control group (185.56±26.64 min). The intraoperative blood loss was (109.44±11.40 ml), which was less than that of the control group (153.13±15.95 ml). The time of the first use of analgesic drugs after the operation (30.22±7.55 min) was later than that of the control group [(26.21±7.42) min], and the differences were statistically significant (P<0.05). At 6h,12h and 48h after surgery,the Ramsay sedation score of the combined group was higher than that of the control group,and the VAS score was lower than that of the control group. The differences were statistically significant （P<0. 05）. At time points of T1,T2,T3 and T4,compared with the control group,the MMSE scores in the combined group increased, and the differences were statistically significant（P<0. 05）. After 7 days,compared with the control group,the proteins of TNF- α , IL-6, CRP and TAU-181 in the combined group decreased and the differences were statistically significant（P<0. 05）. Conclusion For patients after radical gastrectomy for GC, ultrasound-guided TAPB combined with cyclopofol can increase the degree of sedation,reduce pain,improve cognitive function,alleviate inflammatory response,regulate the expression of TAU-181 protein, reduce the incidence of postoperative complications，and be more conducive to postoperative recovery.
关键词
超声引导 /
腹横肌平面阻滞 /
环泊酚 /
胃癌根治术 /
炎症因子 /
人磷酸化TAU-181蛋白
Key words
ultrasound guidance /
transverse abdominis plane block /
cyclopanol /
radical gastric cancer /
inflammatory factors /
human phosphorylated TAU?181 protein
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