胸椎旁神经阻滞联合全身麻醉对肺癌根治术老年患者认知功能的影响

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The Impact of Thoracic Paravertebral Block Combined with General Anesthesia on Cognitive Function in Elderly Patients Undergoing Radical Resection of Lung Cancer/YANG Li， AN Xiaolei， ZHANG Jin. //Medical Innovation of China， 2025， 22（10）： 019-023

[Abstract]Objective： To investigate the effect of thoracic paravertebral block combined with general anesthesiaoncognitive function inelderly patients undergoing radicalresection of lungcancer.Method：Prospectively enrolled 80elderly patientswhounderwentradicalresectionof lung cancer atXuzhou MunicipalHospital Afiliated to Xuzhou Medical University from January 2022 to January 2024.Patients were randomly divided into combined anesthesia group （thoracic paravertebralblock combined with generalanesthesia） and simple general anesthesia group （smple general anesthesia）， with 40 cases in each group. Plasma matrix metaloproteinase-9 （MMP-9）， lipoprotein-phospholipase A2 （Lp-PLA2）， interleukin-6 （IL-6） and tumor necrosis factor- α （TNF -α ） levels were compared between the two groups，and mini-mental state examination （MMSE） and event-related potential p300 were used to evaluate cognitive function in both groups.Result：Thelevels of MMP-9， Lp-PLA2， IL-6 and TNF- α in both groups at 1 and 7 d after surgery were higher than those at 1 d before surgery， and those of the combined anesthesia group were lower than those in the general anesthesia group.Compared with the simple general anesthesia group，the P30Olatency was shorter and the P300 amplitude and MMSE score were higher in the combined anesthesia group at 7d after surgery. Conclusion： Thoracic paravertebral block can effectively reduce neuroinflammatory response and improve cognitive function in elderly patients afterradicalresectionoflung cancer under general anesthesia.

[Key words] Thoracic paravertebral block Radical resection of lung cancer Postoperative cognitive dysfunction Neuroprotection Inflammatory factors

在肺癌治疗领域，肺癌根治术为早期患者提供了有效的治疗手段。（剩余7673字）