超声定位引导在肥胖患者硬膜外麻醉中的应用  

Application of ultrasound-guided positioning to epidural anesthesia in obese patients

作　　者：蓝英年[1] 韦惠[1] 黄霄[1] 周飞人[1] 谭新梅 LAN Ying-nian;WEI Hui;HUANG Wei;ZHOU Fei-ren;AN Xin-mei(Department of Anesthesiology,the People＇s Hospital of Hechi Cit)

机构地区：[1]广西河池市人民医院麻醉科,河池市547000

出　　处：《广西医学》2018年第18期2150-2152,共3页Guangxi Medical Journal

基　　金：广西河池市科学研究与技术开发计划(河科转1439-2)

摘　　要：目的探讨超声定位引导技术在肥胖患者硬膜外麻醉中的应用效果。方法 100例择期行下腹部或下肢手术的肥胖患者,按照随机数字表法分为研究组和对照组,每组50例。研究组采用超声定位引导穿刺行硬膜外穿刺置管,对照组采用传统方法行硬膜外穿刺置管。比较两组麻醉前准备时间、穿刺时间、穿刺次数、穿刺成功率及术后腰痛发生率,分析超声测量硬膜外腔深度与实际穿刺进针深度的相关性。结果研究组的麻醉前准备时间长于对照组,但穿刺时间、穿刺次数及术后腰痛发生率均少于或低于对照组,穿刺成功率高于对照组(均P<0.05)。超声测量硬膜外腔深度与实际穿刺进针深度呈正相关(P<0.05)。结论超声定位引导技术可提高肥胖患者硬膜外麻醉的穿刺成功率,缩短穿刺时间,减少穿刺次数,并降低术后腰痛发生率。Objective To explore the effect of ultrasound-guided positioning technique applied to epidural anesthesia in obese patients. Methods A total of 100 obese patients undergoing elective lower abdominal or lower limb surgery were divided into study group and control group using the random number table method,with 50 cases in each group. The study group received puncture guided by ultrasound positioning to perform epidural catheterization,while the control group received epidural catheterization using traditional methods.The duration of preparation before anesthesia,duration of puncture,frequency of puncture,success rate of puncture,and incidence rate of postoperative lumbago were compared between the two groups. And the correlation of the depth of epidural cavity,determined by ultrasound,with the actual depth of puncture needle inserting was analyzed. Results The duration of preparation before anesthesia was longer,the duration of puncture,frequency of puncture and incidence rate of postoperative lumbago were less or lower,and the success rate of puncture was higher in the study group compared to the controls（ all P〈0. 05）. The depth of epidural cavity,determined by ultrasound,positively correlated with the actual depth of puncture needle inserting（ P〈0. 05）. Conclusion The ultrasound-guided positioning technique can improve the success rate of epidural anesthesia in obese patients,shorten the duration of puncture,reduce the frequency of puncture,and decrease the incidence rate of postoperative lumbago.

关 键 词：硬膜外麻醉 肥胖 超声定位 应用效果 

分 类 号：R614[医药卫生—麻醉学]