超声引导下星状神经节阻滞对脊柱手术患者的应用效果及对消化功能、应激反应的影响

摘要 目的：探讨超声引导下星状神经节阻滞对脊柱手术患者的应用效果及对消化功能、应激反应的影响。方法：选取我院2020年1月到2023年1月收治的60例脊柱手术患者作为研究对象，分为观察组与对照组，每组30例。对照组患者采取静脉全身麻醉，观察组患者在超声引导下行星状神经节阻滞麻醉后再行静脉全身麻醉诱导，对比两组患者术中不同时间生命体征变化，手术前后谷胱甘肽过氧化物酶（GSH-px）、超氧化物歧化酶（SOD）、丙二醛（MDA）相关应激因子变化，并对比两组患者术后2 h、术后6 h、术后12 h和术后24 h视觉模拟量表（VAS）评分，对比患者消化功能恢复时间及15项恢复质量评分量表（QoR-15）评分。结果：T₁到T₄时间观察组SPO₂、HR、MAP、DBP、SBP对比无明显差异（P＞0.05），T₁到T₄时间对照组SPO₂、HR、MAP、DBP、SBP对比差异显著（P＜0.05），T₂和T₃时间观察组与对照组患者SPO₂、HR、MAP、DBP、SBP对比具有显著差异（P＜0.05）；两组患者手术前GSH-px、MDA、SOD对比无明显差异（P＞0.05），术后2h两组患者GSH-px、SOD、MDA均升高，观察组低于对照组（P＜0.05）；观察组患者术后2 h、术后6 h、术后12 h的VAS评分明显低于对照组（P＜0.05），两组患者术后24 h的VAS评分对比无差异（P＞0.05）；观察组患者术后24 h、术后48 h、术后72h的QoR-15评分明显低于对照组（P＜0.05），观察组患者消化功能恢复时间短于对照组（P＜0.05）。结论：超声引导下星状神经节阻滞可稳定患者生命体征，减轻患者应激反应，改善术后短期疼痛情况，促进消化功能恢复。

Effects of Ultrasound Guided Stellate Ganglion Block on Digestive Function and Stress Response in Patients Undergoing Spinal Surgery

ABSTRACT Objective: To investigate the effect of ultrasound guided stellate ganglion block on digestive function and stress response in patients undergoing spinal surgery. Methods: Sixty patients with spinal surgery admitted to our hospital from January 2020 to January 2023 were selected as the research subjects. All patients were divided into an observation group and a control group using a random number table method, with 30 patients in each group. The patients in the control group were given intravenous general anesthesia, and the patients in the observation group were given ultrasound guided planetary ganglion block anesthesia after induction of intravenous general anesthesia. The changes of vital signs of the patients in the two groups at different times during the operation, and the changes of glutathione peroxidase (GSH px), superoxide dismutase (SOD), malondialdehyde (MDA) related stress factors before and after the operation were compared, and the patients in the two groups were compared 2 hours, 6 hours Compare the recovery time of digestive function and the 15 Recovery Quality Rating Scale (QoR-15) scores on the visual analogue scale (VAS) at 12 hours and 24 hours after surgery. Results: There was no difference in SPO₂, HR, MAP, DBP, and SBP between the observation group at T₁ to T₄ (P>0.05), while there was a significant difference in SPO₂, HR, MAP, DBP, and SBP between the control group at T₁ to T₄ (P<0.05). There was a significant difference in SPO₂, HR, MAP, DBP, and SBP between the observation group and the control group at T₂ and T₃ (P<0.05); There was no difference in GSH-px, MDA, and SOD between the two groups of patients before surgery (P>0.05). At 2 hours after surgery, GSH-px, SOD, and MDA increased in both groups of patients, and the observation group was lower than the control group (P<0.05); The VAS scores of the observation group patients at 2 hours, 6 hours, and 12 hours after surgery were lower than those of the control group (P<0.05), and there was no significant difference in the VAS scores between the two groups at 24 hours after surgery (P>0.05); The QoR-15 score of patients at 24h, 48h and 72h after surgery was significantly lower than that of the control group (P<0.05), and the digestive recovery time of patients in the observation group was shorter than that of the control group (P<0.05). Conclusion: Ultrasound guided stellate ganglion block can stabilize patients'' vital signs, reduce stress reactions, improve short-term postoperative pain, and promote digestive function recovery.