【摘要】 目的探讨术前切口部位超前镇痛对开胸手术患者术后恢复的影响。方法随机将70例我院收治的择期进行开胸手术的患者分为试验组（35例）和对照组（35例）。全身麻醉后,试验组沿手术切口给予罗哌卡因进行局部浸润麻醉,对照组给予同等剂量生理盐水。于不同时间点检测两组患者血清中TNF-α、IL-6、IL-10、hs-CRP及PCT的表达,VAS评分,HR、MAP和Pa CO₂。结果随着术后时间的延长,两组患者的VAS评分均呈下降趋势,且试验组患者T₂^T₅时的VAS评分均低于对照组（P<0.05）。随着术后时间的延长,两组患者的血清TNF-α、IL-6、hs-CRP和PCT水平呈升高趋势,且试验组患者T₂^T₅时的TNF-α、IL-6、hsCRP和PCT水平低于对照组,IL-10水平高于对照组（P<0.05）。试验组患者T₂^T₅时的HR、MAP和Pa CO₂较平稳,而对照组的HR、MAP和Pa CO2先升高后降低,且T₂^T₅时试验组的上述指标均优于对照组（P<0.05）。结论开胸手术患者术前给予超前镇痛不仅能够获得良好的术后镇痛效果,而且能够降低术后炎性反应的发生,减少术后呼吸和循环系统并发症的发生。更多还原

【Abstract】 Objective To investigate the effect of preoperative incisional preemptive analgesic on postoperative recovery in patients underwent thoracotomy.Methods A total of 70 patients underwent elective thoracotomy in our hospital were randomly divided into experimental group（35 cases）and control group（35 cases）.After general anesthesia,the experimental group received preoperative incisional preemptive analgesic with ropivacaine and the control group with the same dose of normal saline.The serum levels of TNF-α,IL-6,IL-10,hs-CRP and PCT,the VAS score,HR,MAP and PaCO₂ in the two groups of patients at different time points were monitored.Results With the extension of postoperative time,the VAS scores of both groups showed a downward trend,and the VAS scores from T₂ to T₅ in the experimental group were lower than those of the control group（P<0.05）.With the extension of postoperative time,the serum TNF-α,IL-6,hs-CRP and PCT levels increased in both groups,the levels of TNF-α,IL-6,hs-CRP and PCT from T₂ to T₅ in the experimental group were lower than those in the control group,and the level of IL-10 was higher than that in the control group（P<0.05）.The HR,MAP and PaCO₂ from T₂ to T₅ in the experimental group were stable,while the HR,MAP and PaCO₂ in the control group increased and then decreased,and those indexes from T₂ to T₅ in the experimental group were better than the control group（P<0.05）.Conclusion Preemptive analgesia in patients underwent thoracotomy can not only obtain good postoperative analgesic effect,but also reduce the occurrence of postoperative inflammatory response and the incidence of postoperative respiratory and circulatory complications.更多还原