| 何永冠.超声引导下腹横肌平面阻滞对老年急性阑尾切除术患者氧化应激及血流动力学的影响[J].安徽医药,待发表. |
| 超声引导下腹横肌平面阻滞对老年急性阑尾切除术患者氧化应激及血流动力学的影响 |
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| 投稿时间：2025-08-27 录用日期：2025-09-19 |
| DOI： |
| 中文关键词: 腹横肌平面阻滞 老年 急性阑尾切除术 氧化应激 血流动力学 |
| 英文关键词: |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨超声引导下腹横肌平面阻滞(TAPB)对老年急性阑尾切除术患者氧化应激及血流动力学的影响。方法 选取医院2022年1月至2025年3月收治的老年急性阑尾炎患者96例,随机数字表法分为对照组和观察组各48例。两组均给予常规全身麻醉方案,观察组在常规基础上另给予超声引导下TAPB。对比两组围术期血流动力学、疼痛情况、麻醉药物使用情况、氧化应激反应、认知功能及药物不良反应。结果 两组T1(建立气腹5min)、T2(术毕)时刻的平均动脉压、心率均高于T0(麻醉前)时刻(P <0.05),观察组T1、T2时刻的平均动脉压、心率均低于对照组(P <0.05)。两组术后12h、24h的疼痛视觉模拟评分(VAS)均高于术后2h(P <0.05),观察组术后12h、24h的VAS评分均低于对照组(P <0.05)。观察组丙泊酚用量、瑞芬太尼用量均低于对照组(P<0.05)。两组术后12h、术后 24h的超氧化物歧化酶(SOD)均低于术前,丙二醛(MDA)均高于术前(P<0.05)；观察组术后12h、术后24h的SOD均高于对照组,MDA低于对照组(P<0.05)。两组术前、术后12 h、术后24h的简易精神状态检查(MMSE)量表评分比较差异均无统计学意义(P＞0.05)。两组总不良反应发生率比较差异无统计学意义(P＞0.05)。结论 超声引导下TAPB用于老年急性阑尾切除术有助于稳定患者围术期血流动力学,减轻围术期疼痛感,减少麻醉药物用量,减轻氧化应激反应,对患者认知功能无明显影响,安全可靠。 |
| 英文摘要: |
| Objective To explore the effects of ultrasound-guided transversus abdominis plane block (TAPB) on oxidative stress and hemodynamics in elderly patients undergoing acute appendectomy. Methods 96 elderly patients with acute appendicitis admitted to the hospital from January 2022 to March 2025 were selected and divided into control group and study group by random number table method, 48 cases in each group. Both groups were given conventional general anesthesia regimens, and the study group was also given ultrasound-guided TAPB. The perioperative hemodynamics, pain conditions, the use of anesthetic drugs, oxidative stress response, cognitive function and the occurrence of adverse drug reactions were compared between the two groups. Results The mean arterial pressure and heart rate at T1 (establish pneumoperitoneum for 5 minutes) and T2 (at the end of the operation) in both groups were higher than T0 (before anesthesia) (P <0.05), and the mean arterial pressure and heart rate at T1 and T2 in the study group were lower than control group (P <0.05). The Visual Analogue Scale (VAS) of pain in both groups at 12 hours and 24 hours after surgery was higher than that at 2 hours after surgery (P <0.05), and VAS scores of the study group at 12 hours and 24 hours after surgery were lower than control group (P <0.05). The dosages of propofol and remifentanil in the study group were both lower than control group (P < 0.05). The superoxide dismutase (SOD) levels of both groups at 12 hours and 24 hours after the operation were lower than those before the operation, and the malondialdehyde (MDA) levels were higher than those before the operation (P<0.05). The SOD levels in the study group at 12 hours and 24 hours after the operation were both higher than control group, while the MDA level was lower than control group (P<0.05). There was no statistically significant difference in the scores of the Mini-Mental State Examination (MMSE) scale between the two groups before the operation, 12 hours after the operation, and 24 hours after the operation (P > 0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P > 0.05). Conclusion Ultrasound-guided TAPB administered to elderly patients undergoing acute appendectomy contributes to the stabilization of perioperative hemodynamics, alleviates perioperative pain, reduces the required dosage of anesthetic agents, and mitigates oxidative stress responses. Furthermore, it does not significantly affect cognitive function and demonstrates a favorable safety profile. |
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