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中国临床研究英文版:2021,34(10):1319-1323
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不同麻醉镇痛方式对胫骨骨折内固定患者血清碱性成纤维细胞生长因子的影响
(1. 山西医科大学麻醉学院,山西 太原 030001;2. 山西医科大学第二医院麻醉科,山西 太原 030001)
Influences of different anesthesia and analgesia methods on serum basic fibroblast growth factor in patients with internal fixation of tibial fracture
摘要
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Received:March 03, 2021   Published Online:October 20, 2021
中文摘要: 目的 研究不同麻醉镇痛方式对胫骨骨折患者血清碱性成纤维细胞生长因子的影响。 方法 选山西医科大学附属第二临床医学院2019年2月至2020年2月间胫骨骨折的80例患者进行研究,依麻醉方法分为全麻组和腰硬组,每组40例。测定麻醉前(T0)、术后即刻(T1)、术后24 h(T2)及72 h(T3)外周静脉血中碱性成纤维细胞生长因子(bFGF)水平,并记录对应的生命体征,观察不良反应,一年后电话回访,对比分析两组患者T0~T3时心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)、血清bFGF水平及术后视觉模拟评分法(VAS)评分。 结果在T1、T2和T3时,腰硬组患者血清bFGF水平均高于全麻组,差异有统计学意义( P <0.05);两组患者在各个时间点的血清bFGF水平呈先下降后上升的趋势,且腰硬组的上升幅度大于全麻组,此变化趋势有统计学意义( P <0.01);两组患者在T0、T2及T3时血清bFGF水平均高于T1,差异有统计学意义( P <0.05);在术后2 h时,腰硬组患者VAS评分低于全麻组,差异有统计学意义( P <0.01);两组患者预后情况相比,差异有统计学意义( P <0.05)。 结论 与全身麻醉相比,在胫骨骨折手术时应用椎管内麻醉及硬膜外镇痛可以为患者提供良好的术后镇痛,同时可以使术后早期血清bFGF水平更高,有利于患者骨折愈合。
Abstract:Objective To study the effects of different anesthesia and analgesia Methods on serum basic fibroblast growth factor(bFGF) in patients with tibial fracture. Methods Eighty patients with tibial fracture operated from February 2019 to February 2020 in Second Hospital of Shanxi Medical University were selected and divided into general anesthesia group and spinal-epidural anesthesia group( n =40, each). The levels of bFGF in peripheral venous blood were measured before anesthesia (T0), immediately after operation (T1), 24 hours (T2) and 72 hours (T3) after operation, and the changes of vital signs and adverse reactions were simultaneously observed. The heart rate (HR), mean arterial pressure (MAP), blood oxygen saturation (SpO2), serum bFGF levels at T0~T3 and postoperative visual analogue scale (VAS) scores were analyzed and compared between two groups. Results At T1, T2 and T3, serum bFGF level in spinal-epidural anesthesia group was significantly higher than those in general anesthesia group ( P <0.05). The serum bFGF level showed the trend of first decrease and then increase at each time point in two groups and increased statistically in spinal-epidural anesthesia compared with general anesthesia group ( P <0.01). The serum bFGF level at T0, T2 and T3 was significantly higher than that at T1 in two groups( P <0.05). At 2 hours after operation, VAS score in spinal-epidural anesthesia group was statistically lower than that in general anesthesia group ( P <0.01).There was significant difference in the physical condition between two groups during postoperative follow-up period ( P <0.05) . Conclusion Compared with general anesthesia, intraspinal anesthesia and epidural analgesia can provide superior postoperative analgesia for patients undergoing tibial fracture surgery, and can increase serum bFGF level in the early postoperative period, which is conducive to the recovery of the patients.
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基金项目:山西省自然科学基金(201901D111368)
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