超声引导下胸椎旁神经阻滞在微创经皮肾镜术中的应用效果  

Application effect of ultrasound-guided thoracic paravertebral nerve block in minimally invasive percutaneous nephrolithotomy

作　　者：李优春 欧阳爱平 ZHANG You-chun;OUYANG Ai-ping(Department of Anesthesiology,Ganzhou Hospital Affiliated to Nanehang University,Jiangxi Province,Ganzhou 341000,China)

机构地区：[1]南昌大学附属赣州医院麻醉科,江西赣州341000

出　　处：《中国当代医药》2018年第27期77-79,共3页China Modern Medicine

基　　金：江西省赣州市指导性科技计划项目(GZ2017ZSF185)

摘　　要：目的探讨超声引导下胸椎旁神经阻滞在微创经皮肾镜术中的应用效果。方法选取2017年2月～2018年2月我院接收的60例微创经皮肾镜手术患者作为研究对象,应用随机数字表法将其分为对照组(30例)和研究组(30例)。对照组患者给予硬膜外麻醉,研究组患者给予超声引导下胸椎旁神经阻滞麻醉。比较分析两组患者的麻醉效果、麻醉前(T0)、麻醉完成后5 min(T_1)、手术开始时(T_2)、手术结束时(T_3)的心率(HR)、收缩压(SBP)和舒张压(DBP)及术后不良反应发生情况。结果研究组患者的麻醉起效时间、麻醉时间、手术时间均短于对照组,差异有统计学意义(P<0.05)。研究组患者在T_1时间点的SBP和DBP均高于对照组,差异有统计学意义(P<0.05)。研究组患者不良反应总发生率为3.33%,明显低于对照组的23.33%,差异有统计学意义(P<0.05)。结论超声引导下胸椎旁神经阻滞在微创经皮肾镜术中的应用效果显著,不良反应少,术后恢复快,可在临床中推广应用。Objective To explore the application effect of uhrasound-guided thoracic paravertebral nerve block in min- imally invasive pereutaneous nephrolithotomy. Methods A total of 60 cases of patients who undergone minimally inva- sire pereutaneous nephrolithotomy in our hospital from February 2017 to February 2018 were selected as the research subjects, and they were divide into the control group （30 cases） and the study group （30 cases） according to tie random number table method. The control group was given epidural anesthesia, and the study group was treated with ultra- sound-guided thoracic paravertebral block anesthesia. The anesthetic effect, heart rate （HR）, systolic pressure （SBP） and diastolic pressure （DBP） before anesthesia （T0）, 5 rain af, er anesthesia （T1）, start of surgery （T2）, and end of surgery （T3）, and postoperative adverse reactions were compared and analyzed between two groups. Results The onset time, anesthetic time and operative time of the study group were lower than those of the control group, and the differences were statistically significant （P〈0.05）. The SBP and DBP at T1 time point in the study group were higher than those in the control group, and the differences were statistically significant （P〈0.05）. The total rate of adverse reactions in the study group was 3.33%, which was significantly lower than that of the control group （23.33%）, and the difference was statistically significant （P〈0.05）. Conclusion Ultrasound guided thoracic paravertebral nerve block is effective in mini- really invasive pereutaneous nephrolithotomy, with fewer adverse reactions and faster postoperative recovery, which can be widely applied in clinical practice.

关 键 词：超声 胸椎旁神经阻滞 微创经皮肾镜术 

分 类 号：R699.2[医药卫生—泌尿科学]