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超声引导下腹横肌平面阻滞对子宫内膜癌根治性切除术患者中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值及全身免疫炎症指数的影响。

Effect of ultrasound-guided transverse abdominal plane block on neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune inflammation index in patients undergoing radical resection of endometrial carcinoma.

作者信息

Wang Changxu, Fan Shiwen, Gu Dengfeng, Deng Jiaojiao, Ma Baobao, Xie Liping, Zhang Hong

机构信息

Department of Anesthesiology, First Affiliated Hospital, Shihezi University, Shihezi, China.

Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

PLoS One. 2024 Dec 5;19(12):e0315175. doi: 10.1371/journal.pone.0315175. eCollection 2024.

Abstract

OBJECTIVE

The purpose of this trial was to explore the effects of the ultrasound-guided transverse abdominal plane block (TAPB) on the systemic immune-inflammatory index (SII), peripheral blood neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) in patients undergoing radical resection of endometrial carcinoma.

METHODS

This trail was registered in the Chinese Clinical Trial Registry (ChiCTR2300072186, www.chictr.org/; approval date: 2023-06-06). In the study, a total of 90 patients who were scheduled for radical resection of endometrial carcinoma were selected, and they were randomized to receive ultrasound-guided TAPB combined with general anesthesia (GA) or either GA. The primary outcomes were the values of NLR、PLR and SII which were obtained at postoperative 24 hours and 72 hours. Other observational indicators included: the counts of neutrophil, lymphocyte, and platelet; the numbers of effective press of the analgesic pump; postoperative pain intensity; remifentanil consumption; and adverse reactions.

RESULTS

The values of preoperative peripheral blood neutrophil, platelet, lymphocyte, NLR, PLR, and SII did not differ between the two groups (P>0.05). The TAP+GA group exhibited significantly reduced levels of neutrophil, NLR, and SII at 24 and 72 hours post-surgery than the GA group (P<0.05). However, there were no significant differences in the values of PLR between the two groups (P>0.05). Compared with the GA group, the VAS scores at 6 hours, 12 hours, and 24 hours after surgery in the TAP+GA group were significantly decreased, and the intraoperative consumption of remifentanil and the numbers of postoperative analgesic pump presses were significantly reduced (P<0.05). Moreover, the incidence of postoperative nausea and vomiting was reduced considerably in the TAP+GA group (P<0.05).

CONCLUSIONS

Ultrasound-guided TAPB can effectively lower the values of postoperative neutrophil, NLR, and SII, improve postoperative pain intensity, decrease opioid consumption, and reduce the incidence of postoperative nausea and vomiting.

摘要

目的

本试验旨在探讨超声引导下腹横肌平面阻滞(TAPB)对子宫内膜癌根治性切除术患者全身免疫炎症指标(SII)、外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)的影响。

方法

本试验在中国临床试验注册中心注册(ChiCTR2300072186,www.chictr.org/;批准日期:2023年6月6日)。在本研究中,共选取90例计划接受子宫内膜癌根治性切除术的患者,将他们随机分为接受超声引导下TAPB联合全身麻醉(GA)组或单纯GA组。主要观察指标为术后24小时和72小时时的NLR、PLR和SII值。其他观察指标包括:中性粒细胞、淋巴细胞和血小板计数;镇痛泵有效按压次数;术后疼痛强度;瑞芬太尼用量;以及不良反应。

结果

两组患者术前外周血中性粒细胞、血小板、淋巴细胞、NLR、PLR和SII值无差异(P>0.05)。TAP+GA组术后24小时和72小时时中性粒细胞、NLR和SII水平明显低于GA组(P<0.05)。然而,两组间PLR值无显著差异(P>0.05)。与GA组相比,TAP+GA组术后6小时、12小时和24小时的视觉模拟评分(VAS)显著降低,术中瑞芬太尼用量和术后镇痛泵按压次数显著减少(P<0.05)。此外,TAP+GA组术后恶心呕吐发生率显著降低(P<0.05)。

结论

超声引导下TAPB可有效降低术后中性粒细胞、NLR和SII值,改善术后疼痛强度,减少阿片类药物用量,并降低术后恶心呕吐的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1858/11620674/484e23b1456e/pone.0315175.g001.jpg

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