目的 探讨硬膜外腔阻滞复合全麻与肋间神经阻滞复合全麻对开胸手术患者早期恢复质量的影响。方法 选取择期行开胸手术患者76例，随机分为两组，硬膜外阻滞复合全麻组（E组） 、肋间神经阻滞复合全麻组（C组），每组38例。E组行硬膜外穿刺置管，术中0.2%罗哌卡因维持；C组行切口及上下肋间神经阻滞，两组全麻诱导及维持一致。采用术后恢复质量量表(quality of recovery QoR-40）对患者进行术前１天、术后３天恢复质量评分；采用视觉模拟评分法（Visual analogue scale VAS）对两组患者进行拔管后4h、8h、12h、24h 安静和活动后的VAS评分；同时记录首次下床活动时间及住院时间。结果 与C组相比，E组在术后３天QoR-40各项评分均高于C组（P<0.05）；E组静息和运动状态下术后各时间点VAS评分降低（P<0.05）；E组首次下床活动时间较早，住院时间较C组减少(P<0.05)。 结论 硬膜外阻滞复合全身麻醉用于开胸手术患者，不仅镇痛效果良好，还能明显提高术后早期恢复质量，缩短住院时间。

To observe the effect of early postoperative recovery in patients with epidural and intercostal nerve block combined with?general anesthesia who undergoing thoracotomy. Methods Forward-looking the 78 patients who underwent thoracotomy in our hospital from October 2019 to October 2020. Patients were randomly devided into two groups:Epidural Combined General Anesthesia Group (Group E) , intercostal nerve block combined General Anesthesia Group (Group C) , n=38, Before induction, T6-7 epidural catheterization was performed in Group E,, and intercostal nerve block was performed in Group C, The two groups were consistent with the same general anesthesia.QoR-40 scale was used to evaluate the quality of Recovery before the surgery and 3 days after surgery,Recorded VAS score of postoperative resting and moving actions 4 h , 8 h , 12 h and 24 h after the operation .Recorded the time of first movement out of bed and time of hospitalization .Results Compared with Group C,The QoR-40 scores of Group E were higher (P <0.05), the VAS scores of Group E were significantly lower (P <0.05) , the first time of get out of bed was earlier in Group E and the Hospital length of stay was significantly lower in group E.Conclusion Epidural combined with general anesthesia can not only relieve pain effectively, but also improve the quality of early recovery and shorten the time of hospitalization.

内蒙古自治区自然科学基金资助项目