神经刺激器定位下阴部神经阻滞用于混合痔术后镇痛的疗效观察  

Neurostimulator-guided pudendal block as postoperative analgesic therapy for postoperative pain of mixed hemorrhoids surgery

作　　者：夏仕俊 吴文江[1] 范小华[2] Xia Shijun;Wu Wenjiang;Fan Xiaohua(Department of Anorectal Diseases, Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen 518000, Guang dong, China;Department of Anorectal Diseases, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou 510030, Guangdong, China)

机构地区：[1]广州中医药大学深圳医院肛肠科,广东深圳518000 [2]广东省中医院肛肠科,广东广州510030

出　　处：《结直肠肛门外科》2019年第5期570-573,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨神经刺激器定位下阴部神经阻滞用于混合痔术后镇痛的临床疗效。方法选取广州中医药大学深圳医院肛肠科2018年9月至2019年2月收治的100例Ⅲ度、Ⅳ度混合痔患者为研究对象,随机分为观察组和对照组,每组各50例。观察组予神经刺激器定位下阴部神经阻滞进行痔术后镇痛,对照组予亚甲蓝注射皮下神经阻滞镇痛。比较两组在术后首次疼痛时间、术后48h内疼痛评分及术后48h内追加止痛药物干预的情况。结果观察组的术后首次疼痛时间较对照组延后,两组比较,差异有统计学意义(P<0.05)。观察组术后48h内疼痛评分大于4分以及追加止痛药物患者的占比低于对照组,差异均有统计学意义(均P<0.05)。结论与亚甲蓝注射神经阻滞相比,神经刺激器定位下阴部神经阻滞用于Ⅲ度、Ⅳ度混合痔术后镇痛疗效更优,且安全性良好。Objectives To investigate the analgesic effect of neurostimulator-guided pudendal block in patients with mixed hem orrhoids after surgery. Methods One hundred patients with Grade III and IV mixed hemorrhoids were recruited from the Depart ment of Anorectal Diseases, Shenzhen Hospital of Guangzhou University of Chinese Medicine between September 2018 and Febru ary 2019. They were recruited and randomly assigned to the treatment group and control group, with 50 cases in each group. The treatment group received neurostimulator-guided pudendal block as postoperative analgesic therapy, and the control group re ceived percutaneous nerve block with methylene blue injection. The followings were compared between the two groups: the time to first postoperative pain, the pain score 48 hours after surgery, and the additional use of analgesics within 48 hours after sur gery. Results The time to first postoperative pain was significantly longer in the treatment group than in the control group (P < 0.05). The proportion of patients with a pain score greater than 4 at 48 hours after surgery and the proportion of patients requir ing additional use of analgesics were significantly lower in the treatment group than in the control group (P < 0.05). Conclusion Compared with percutaneous nerve block with methylene blue injection, neurostimulator-guided pudendal block was more effec tive for patients with Grade III and IV mixed hemorrhoids after surgery and with gratifying safety.

关 键 词：混合痔术后 阴部神经阻滞 神经刺激器 

分 类 号：R657.1[医药卫生—外科学]