胸段硬膜外阻滞对急性重症胰腺炎患者镇痛及肾功能的影响

Effects of thoracic epidural block on analgesia and renal function in patients with severe acute pancreatitis

摘要:

目的 探究胸段硬膜外阻滞（TEB）对急性重症胰腺炎（SAP）患者镇痛及肾功能的影响。方法 选取2022年7月—2025年7月南京明基医院与江苏省人民医院纳入的80例SAP患者作为研究对象，按信封抽签法随机分为静脉组（40例）和TEB组（40例）。静脉组接受静脉舒芬太尼镇痛方案，TEB组接受胸段硬膜外阻滞镇痛方案。比较两组生命体征指标、疼痛及病情严重程度、炎症因子、肾功能指标及不良事件。结果 TEB组的心率、呼吸频率低于静脉组，氧合指数高于静脉组（P <0.05）。治疗后，TEB组视觉模拟评分法评分、Ranson评分均低于静脉组（P <0.05）；TEB组白细胞介素-6、白细胞介素-1β、肿瘤坏死因子-α均低于静脉组（P <0.05）；TEB组的肌酐、尿酸、尿素氮均低于静脉组（P <0.05）。两组不良事件发生率比较，差异无统计学意义（P >0.05）。结论 TEB可有效缓解SAP患者疼痛，减轻炎症反应，并对肾功能具有一定保护作用。

Abstract:

Objective To investigate the effects of thoracic epidural block (TEB) on analgesia and renal function in patients with severe acute pancreatitis (SAP).Methods A total of 80 patients with SAP who were enrolled at Nanjing BenQ Hospital and Jiangsu Provincial People's Hospital from July 2022 to July 2025 were selected. Using the envelope method, they were randomly divided into an intravenous group (n = 40) and a TEB group (n = 40). The intravenous group received intravenous sufentanil analgesia, whereas the TEB group received thoracic epidural block analgesia. Vital signs, pain and disease severity, inflammatory factors, renal function indices, and adverse events were compared between the two groups.Results Heart rate and respiratory rate were lower and the oxygenation index was higher in the TEB group than in the intravenous group (P < 0.05). After treatment, visual analog scale and Ranson scores were lower in the TEB group than in the intravenous group (P < 0.05). Interleukin-6, interleukin-1β, and tumor necrosis factor-α levels were lower in the TEB group (P < 0.05). Serum creatinine, uric acid, and blood urea nitrogen levels were also lower in the TEB group than in the intravenous group (P < 0.05). The incidence of adverse events did not differ significantly between the two groups (P > 0.05).Conclusion TEB effectively relieves pain and reduces inflammation in patients with SAP and has a protective effect on renal function.