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Objective To analyze the clinical effect of ultrasound-guided quadratus lumborum block(QLB)and erector spinae plane block(ESPB)in elderly patients with laparoscopic colorectal cancer surgery.Methods A total of 75 elderly patients who underwent elective laparoscopic radical resection of colorectal cancer in wenzhou central hospital,from August 2021 to March 2022 were selected and divided into quadratus lumborum group(group Q,n=25),erector spinae muscle group(group E,n=25)and group C(n=25).Group Q received QLB combined with general anesthesia,group E received ESPB combined with general anesthesia,the group C was given tracheal intubation with total intravenous general anesthesia.The perioperative anesthesia and analgesic dosage,postoperative recovery quality,resting and cough visual analogue scale(VAS)scores were compared among the groups.Results In contrast to the group C,the number of effective PCIA compressions,the dose of sufentanil,and the analgesic rescue rate were significantly decreased in groups Q and E(P<0.05);In contrast to the the group C,the spontaneous breathing,eye opening and tracheal extubation time of patients in group Q and group E were apparently shortened(P<0.05),and patients in group Q and group E recovered indoor nausea and vomiting,lethargy,restlessness and respiratory depression The number of cases was apparently reduced(P<0.05);at each time point from 2 to 48 hours after operation,compared with the group C,the VAS scores at rest and cough in groups Q and E were apparently decreased(P<0.05).However,there was no significant difference in the above indicators between the group Q and the group E(all P>0.05).Conclusion Ultrasound-guided QLB and ESPB for laparoscopic colorectal cancer surgery can both improve the quality of recovery and achieve satisfactory analgesia in elderly patients.
RESUMEN
Objective To study the effect of compound matrine injection combined with chemotherapy on the immune function and life quality of elderly patients with colorectal cancer. Methods Seventy patients with colorectal cancer treated in Shanghai Jiao Tong University Affiliated Sixth People′s Hospital South Campus from January 2010 to December 2013 were involved in this survey. They were divided into the control group and the observation group randomly,each group had 35 cases,the control group was treated with chemotherapy only, the observation group was treated with compound matrine injection combine with chemotherapy. The curative effect,life quality and immune function in the two groups were compared. Results The number of complete remission patients in the observation group was 8 cases ( 22. 86%) ,the number of partial remission cases was 16 cases ( 45. 71%) , the effective rate was 68. 57%, while the control group had 4 cases of complete remission (11. 43%),11 cases of partial remission (31. 43%),the effective rate was 42. 86% (Z=-2. 259,P=0. 024) . In the observation group,life quality was significantly improved in 10 cases (28. 57%),improved in 19 cases ( 54. 29%) ,the effective rate was 82. 86%,while in the control group,life quality was significantly improved in 4 cases ( 11. 43%) ,and improved in 10 cases ( 28. 57%) ,the effective rate was only 40%. The improvement rate of the two groups was statistically significant ( Z=-3. 497,P=0. 000) . Before treatment,the immune function indexes of patients in the two groups were close ( P>0. 05) ,after treatment,the immune function in both groups were significantly improved,CD3+,CD4+,CD4+/CD8+ levels of patients in the observation group were higher than those in the control group,while the CD8+ level in the observation group was lower than that of the control group ( t=-3. 968,P=0. 000;t=-5. 351,P=0. 000;t=-5. 474,P=0. 000;t=6. 407,P=0. 000) . The follow?up time of the two groups was 36 months. After 36 months,the survival rates of the observation group and the control group were 85. 7% (30/35) and 80. 0% (28/35) respectively,and the difference was not statistically significant (χ2=0. 402,P=0. 526) . Conclusion Compound matrine injection combined with chemotherapy can significantly improve the clinical efficacy of elderly patients with colorectal cancer,improve the immune function and quality of life,it is worthy of clinical application.