胡春阳　金莲锦　于仁志　芦相玉　周旋　王明欢

[摘要] 目的 探討研究喉罩通气复合肋间神经阻滞在老年乳腺癌术后麻醉恢复期中的护理效果。 方法 将2016年5月～2017年5月于本院行老年乳腺癌术治疗患者中抽出60例，将其分成观察、对照两组。其中，对照组采取喉罩全麻+常规护理，观察组选择喉罩通气复合肋间神经阻滞+强化护理模式进行干预，比较两组患者的临床效果。结果 观察组并发症发生率较对照组对应值低（26.67%<56.67%）；观察组T1～T3时间段的应激反应指标均较对照组对应值稳定；观察组护理满意度评分较对照组对应值高（P<0.05）。 结论 针对行老年乳腺癌术治疗患者采取喉罩通气复合肋间神经阻滞作麻醉首选方案，并在其术后麻醉恢复期加强患者护理干预，有效降低其机体应激反应的同时有利于减少患者并发症发生次数，安全性高，其护理满意度显著，值得临床大力推广。

[关键词] 喉罩通气复合肋间神经阻滞；老年乳腺癌；术后麻醉恢复期；护理

[中图分类号] R473.73 [文献标识码] B [文章编号] 1673-9701（2018）26-0144-03

Observation on the postoperative anesthesia recovery effect and nursing on the elderly patients with breast cancer after laryngeal mask ventilation combined with intercostal nerve block

HU Chunyang JIN Lianjin YU Renzhi LU Xiangyu ZHOU Xuan WANG Minghuan

Department of Anesthesiology， the Affiliated Hongqi Hospital of Mudanjiang Medical University， Mudanjiang 157000， China

[Abstract] Objective To explore and study the nursing effect of laryngeal mask ventilation combined with intercostal nerve block in postoperative anesthesia recovery of elderly patients with breast cancer. Methods From May 2016 to May 2017， 60 patients who were treated in our hospital for geriatric breast cancer were selected. They were divided into observation group and control group. Among them， the control group was given general anesthesia by laryngeal mask and general nursing. The observation group was given laryngeal mask ventilation combined intercostal nerve block+intensive nursing care model for intervention. The clinical effects were compared between the two groups of patients. Results The complication rate in the observation group was lower than that in the control group（26.67%<56.67%）； the stress response indicators in the observation group from T1 to T3 were stable compared with the corresponding values in the control group. The nursing satisfaction score in the observation group was higher than that in the control group（P<0.05）. Conclusion Laryngeal mask ventilation combined with intercostal nerve block is the preferred choice for anesthesia for elderly patients undergoing breast cancer surgery， and the patient care intervention was strengthened during its postoperative anesthesia recovery period， which effectively reduces the body's stress response， and at the same time， is beneficial to reducing the incidence of complications， with high safety， and significant nursing satisfaction. It is therefore worthy of clinical promotion.

[Key words] Laryngeal mask ventilation combined with intercostal nerve block； Elderly breast cancer； Postoperative anesthesia recovery； Nursing care

近年来，有相关临床研究结果表明，行老年乳腺癌术治疗患者术后均会受其麻醉、管道、心理等多个因素刺激而在麻醉恢复期引发一系列并发症状，对其预后改善及健康恢复进度均会构成不利影响[1-2]。因此，针对老年乳腺癌患者围术期间，需采取针对其病情特点及手术特殊性给予合理手术麻醉措施，并在患者术后加以针对性护理措施进行干预，对提高其治疗效率和稳定术中体征指标具有较好的临床价值[3-4]。综合上述观点，本次研究现抽选60例于本院收治的老年乳腺癌患者作研究对象行临床分析，同时主张倡导应用喉罩通气复合肋间神经阻滞作麻醉主要方式，前者能将患者气道损伤程度降低至最低水平，后者应用可缓解其术后的机体应激反应，效果显著，是现下倡导推广的麻醉方案之一，现报道如下。

1 资料与方法