腹横肌平面阻滞用于腹股沟疝修补术的效果分析  

Effects of transversus abdominis plane block in inguinal hernia repair

作　　者：徐晓红[1] 田伟千[1] 武茜[1] 汤洋[1] 崔耀梅[1] 杨程[1] XU Xiao-hong;TIAN Wei-qian;WU Qian;TANG Yang;CUI Yao-mei;YANG Cheng(Department of Anesthesiology,Affiliated Hospital of Nanjing University of TCM,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院麻醉科,南京210029

出　　处：《中国医学前沿杂志（电子版）》2018年第9期93-96,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的分析腹横肌平面(transversus abdominis plane,TAP)阻滞用于腹股沟疝修补术的效果。方法选取本院2017年1月至2017年10月行单侧腹股沟疝修补术的136例老年患者为研究对象,采用电脑随机分配方式将其分为研究组和对照组,每组各68例。对照组患者采用喉罩全身麻醉,研究组患者采用超声引导下TAP阻滞联合全身麻醉,比较两组患者麻醉前(T0)、切皮时(T1)、疝囊剥离时(T2)、缝皮时(T3)、手术结束时(T4)的平均动脉压(mean arterial pressure,MAP)和心率(heart rate,HR)、术后并发症发生率及术后2、4、6、8、12、24小时的视觉模拟评分法(visual analogue scale,VAS)评分。结果 T2、T3时,研究组患者MAP_均显著低于对照组(P_均<0.05);T1、T3、T4时,研究组患者HR均显著低于对照组(P_均<0.05);术后2、4、6、8、12小时,研究组患者VAS评分均显著低于对照组(P_均<0.05)。研究组患者术后恶心、呕吐、胸闷及尿潴留的发生率均显著低于对照组(P_均<0.05)。结论超声引导下TAP阻滞用于腹股沟疝修补术,患者术中血流动力学稳定,镇痛效果较好,术后并发症少。ObjectiveTo explore effects of transversus abdominis plane （TPA） block in inguinal hernia repair. Method136 elderly patients underwent unilateral inguinal hernia repair in our hospital from January 2017 to October 2017 were selected as subjects, they were divided into study group and control group by computer randomly, 68 cases in each group. Control group patients received general anesthesia, study group patients received ultrasound-guided TAP block combined with general anesthesia, the mean arterial pressure （MAP） and heart rate （HR） before anesthesia （T0）, at skin incision （T1）, at hernial sac dissection （T2）, at suture the skin （T3）, at the end of surgery （T4）, the incidence of postoperative complications and visual analogue scores （VAS） scores 2, 4, 6, 8, 12, 24 hours after surgery were compared between the two groups. ResultAt T2 and T3, MAP of study group was signiffcantly lower than that of control group （Pall〈0.05）; at T1, T3 and T4, HR of study group was signiffcantly lower than that of control group （Pall〈 0.05）; 2, 4, 6, 8, and 12 hours after operation, the VAS scores of study group were signiffcantly lower than those of control group （Pall〈 0.05）. The incidence of postoperative nausea, vomiting, chest tightness and urinary retention of study group were signiffcantly lower than those of control group （Pall〈 0.05）. ConclusionUltrasound-guided TAP block for inguinal hernia repair has stable hemodynamics, good analgesic effect and fewer postoperative complications

关 键 词：腹横肌平面阻滞 腹股沟疝修补术 血流动力学 镇痛 

分 类 号：R614[医药卫生—麻醉学]