胸腔镜直视下椎旁阻滞在单孔胸腔镜肺癌手术镇痛中的应用

天津科技 ›› 2025, Vol. 52 ›› Issue (08): 54-57.

胸腔镜直视下椎旁阻滞在单孔胸腔镜肺癌手术镇痛中的应用

庞靖桦, 宋承军

宁波市奉化区人民医院（宁波市奉化区人民医院医共体总院）胸外科浙江宁波 315500

收稿日期:2025-07-03 出版日期:2025-08-25 发布日期:2026-01-05
基金资助:
2022年度宁波市奉化区社会发展科研攻关项目“胸腔镜直视下椎旁神经阻滞对单孔胸腔镜肺癌手术术后镇痛效果的临床研究”（202209205）

Application of paravertebral block under direct thoracoscopic vision in analgesia for single-port thoracoscopic lung cancer surgery

PANG Jinghua, SONG Chengjun

Department of Thoracic Surgery,Ningbo Fenghua District People's Hospital < Medical Consortium Headquarters of Ningbo Fenghua District People's Hospital>,Ningbo 315500,China

Received:2025-07-03 Online:2025-08-25 Published:2026-01-05

摘要/Abstract

摘要： 选取100例2022年9月1日—2024年8月31日在宁波市奉化区人民医院胸外科行单孔胸腔镜肺癌手术的患者,采用随机数字表法,将其分为胸腔镜直视下椎旁神经阻滞组（n=50）和空白对照组（n=50）,观察胸腔镜直视下椎旁神经阻滞对单孔胸腔镜肺癌手术患者术后的镇痛效果。椎旁神经阻滞组手术结束前,在T4—T6间隙进行胸腔镜直视下多点椎旁神经阻滞,对照组未做任何处置。观察并记录两组患者术后第6、12、24、48、72 h静息和活动视觉模拟评分法（VAS）评分;镇痛相关不良反应、补充镇痛药物使用情况;临床预后指标,包括术后肺部并发症等。与对照组相比,椎旁神经阻滞组在术后第6、12、24、48、72 h的静息和活动VAS评分都有明显降低,差异均有统计学意义（P<0.05）。胸腔镜直视下的椎旁神经阻滞技术通过精准定位,直接作用于疼痛源,能够显著减轻单孔胸腔镜肺癌手术患者术后的疼痛感,提升患者的舒适度,有利于患者康复。

关键词: 术后镇痛, 椎旁神经阻滞, 单孔胸腔镜手术, 视觉模拟评分法

Abstract: A total of 100 patients who underwent single-port thoracoscopic lung cancer surgery at the Department of Thoracic Surgery,Fenghua District People's Hospital,Ningbo City from September 1,2022 to August 31,2024 were selected and randomly divided into a thoracoscopic direct vision paravertebral nerve block group （n=50） and a control group （n=50） using a random number table. The analgesic effect of paravertebral nerve block under direct thoracoscopic vision on patients undergoing single-port thoracoscopic lung cancer surgery was observed. Before the end of the surgery,the paravertebral nerve block was performed under direct thoracoscopic vision in the paravertebral nerve block group （T4-T6 interspace）,while no intervention was made in the control group. The postoperative VAS scores for rest and activity were recorded at 6,12,24,48,and 72 hours in both groups;adverse reactions related to analgesia and the use of additional analgesic drugs were also observed;clinical prognosis indicators,including postoperative pulmonary complications,were evaluated. Compared with the control group,the paravertebral nerve block group showed significant reductions in VAS scores for rest and activity at 6,12,24,48,and 72 hours after surgery,with all differences being statistically significant. Paravertebral nerve block technology under direct thoracoscopic vision,through precise localization and direct action on the source of pain,can significantly reduce postoperative pain in patients undergoing single-port thoracoscopic lung cancer surgery,improve patient comfort,and facilitate postoperative recovery.

Key words: postoperative analgesia, paravertebral nerve block, single-port thoracoscopic surgery, VAS score

中图分类号:

R655.3

庞靖桦, 宋承军. 胸腔镜直视下椎旁阻滞在单孔胸腔镜肺癌手术镇痛中的应用[J]. 天津科技, 2025, 52(08): 54-57.

PANG Jinghua, SONG Chengjun. Application of paravertebral block under direct thoracoscopic vision in analgesia for single-port thoracoscopic lung cancer surgery[J]. TIANJIN SCIENCE & TECHNOLOGY, 2025, 52(08): 54-57.

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