超声引导下髂腹股沟髂腹下神经阻滞用于老年腹股沟疝手术的安全性及有效性探究  

作　　者：沈亚芳[1,2] 李泉[1,3] 

机构地区：[1]南京医科大学,江苏南京210029 [2]昆山市第一人民医院麻醉科,江苏昆山215300 [3]上海东方医院麻醉科,上海200000

出　　处：《湖南中医药大学学报》2016年第A02期810-811,共2页Journal of Hunan University of Chinese Medicine

摘　　要：目的：分析超声引导下髂腹股沟髂腹下神经阻滞用于老年腹股沟疝手术效果,评价超声技术在麻醉中的有效性.方法： 选取我院 2015 年 1 月-2016年 6 月收治老年腹股沟疝76例为研究对象,ASA Ⅰ-Ⅱ级,随机分为超声法组和传统法组,传统法组采取髂腹股沟髂腹下神经阻滞,超声法组患者在超声引导下行髂腹股沟髂腹下神经阻滞.分析不同时间点患者血流动力学（MBP、SPO2、HR、RR等）变化以及VAS 评分变化,记录阻滞起效时间和维持时间,记录患者不良反应情况.结果： （1）超声法组感觉神经阻滞起效时间（6.3±1.0）min 显著短于传统法组（9.5±2.1）min（P〈0.05）,超声法组感觉神经阻滞维持时间（453±51）min显著长于传统法组（374±46）min（P〉0.05）.（2）T0时刻和麻醉阻滞后1-10min 以及手术结束时,两组患者血流动力学指标无明显差异（P〉0.05）,T1 和T2 时刻超声法组VAS 评分显著低于传统法组（P〈0.05）.（3）超声法组右美托咪碇和舒芬太尼用量显著少于传统法组右美托咪啶和舒芬太尼用量.（4）两组患者术中和术后常见不良反应为术中体动、呼吸抑制、躁动、麻醉失败等,超声法组并发症发生率显著小于传统法组（P〈0.05）.结论：老年腹股沟疝患者在超声引导下行髂腹股沟髂腹下神经阻滞,效果明确,安全性高.Objective：To analyze the ultrasound-guided nerve block ilioinguinal Iliohypogastric for elderly inguinal hernia surgery results, evaluate the effectiveness of ultrasound in anesthesia.Methods：Seventy-six patients with elderly inguinal hernia in hospital were selected, ASA I ~ II level ,patients were divided into observer group and control group,control group patients were taken trentment of Ilioinguinal nerve block Iliohypogastric,observer group patients were taken trentment of Ultrasound guided ilioinguinal nerve block Iliohypogastric.The change of Hemodynamics in patients （MBP, SPO2, HR, RR, etc.） and VAS were analyzed, block onset time, duration and adverse reactions were recorded.Results： （1） the observation group of sensory block onset time （6.3±1.0） min was significantly shorter than the control group （9.5±2.1） min （P 〈0.05）, the observation group sensory block duration （453±51） min was significantly longer than the control group （374±46） min （P〉 0.05）. （2） T0 time and after the anesthetic block 1 ~ 10min and the end of surgery, hemodynamic parameters in patients with no significant difference between the two groups （P〉 0.05）, T1 and T2 time observation group VAS scores were significantly lower than the control group （P 〈0.05）. （3） observation of propofol group （30.3±18.4） mg and the amount of ketamine （32.9±15.7） was significantly less than the control group, propofol （71.2±16.3） mg and the amount of ketamine （86.4±16.7） mg （P 〈0.05 ）. （4） two groups of patients undergoing surgery for the common adverse reactions and body movement, respiratory depression, agitation, etc. anesthesia failure to observe the complication rate was significantly lower than the control group （P 〈0.05）.Conclusions：Inguinal hernia in elderly patients with ultrasound-guided nerve block ilioinguinal Iliohypogastric effect clear, it is safe.

关 键 词：老年腹股沟疝 神经组织 超声引导 髂腹股沟髂腹 安全性 

分 类 号：R2[医药卫生—中医学]